• K Robin Yabroff, Emily C Dowling, Gery P Guy, Matthew P Banegas, Amy Davidoff, Xuesong Han, Katherine S Virgo, Timothy S McNeel, Neetu Chawla, Danielle Blanch-Hartigan, Erin E Kent, Chunyu Li, Juan L Rodriguez, Janet S de Moor, Zhiyuan Zheng, Ahmedin Jemal, and Donatus U Ekwueme.
• K. Robin Yabroff, Matthew P. Banegas, Neetu Chawla, Danielle Blanch-Hartigan, Erin E. Kent, and Janet S. de Moor, National Cancer Institute, Bethesda; Timothy S. McNeel, Information Management Services, Calverton, MD; Emily C. Dowling, Massachusetts General Hospital, Boston; Danielle Blanch-Hartigan, Bentley University, Waltham, MA; Gery P. Guy Jr, Chunyu Li, Juan L. Rodriguez, and Donatus U. Ekwueme, Centers for Disease Control and Prevention; Xuesong Han, Zhiyuan Zheng, and Ahmedin Jemal, American Cancer Society; Katherine S. Virgo, Emory University, Atlanta, GA; Amy Davidoff, Yale School of Public Health, New Haven, CT; and Neetu Chawla, Kaiser Permanente Northern California, Oakland, CA. robin.yabroff@hhs.gov.
• J. Clin. Oncol. 2016 Jan 20; 34 (3): 259-67.

PurposeTo estimate the prevalence of financial hardship associated with cancer in the United States and identify characteristics of cancer survivors associated with financial hardship.MethodsWe identified 1,202 adult cancer survivors diagnosed or treated at ≥ 18 years of age from the 2011 Medical Expenditure Panel Survey Experiences With Cancer questionnaire. Material financial hardship was measured by ever (1) borrowing money or going into debt, (2) filing for bankruptcy, (3) being unable to cover one's share of medical care costs, or (4) making other financial sacrifices because of cancer, its treatment, and lasting effects of treatment. Psychological financial hardship was measured as ever worrying about paying large medical bills. We examined factors associated with any material or psychological financial hardship using separate multivariable logistic regression models stratified by age group (18 to 64 and ≥ 65 years).ResultsMaterial financial hardship was more common in cancer survivors age 18 to 64 years than in those ≥ 65 years of age (28.4% v 13.8%; P < .001), as was psychological financial hardship (31.9% v 14.7%, P < .001). In adjusted analyses, cancer survivors age 18 to 64 years who were younger, female, nonwhite, and treated more recently and who had changed employment because of cancer were significantly more likely to report any material financial hardship. Cancer survivors who were uninsured, had lower family income, and were treated more recently were more likely to report psychological financial hardship. Among cancer survivors ≥ 65 years of age, those who were younger were more likely to report any financial hardship.ConclusionCancer survivors, especially the working-age population, commonly experience material and psychological financial hardship.© 2015 by American Society of Clinical Oncology.

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