Cancer survivors often forgo needed care due to cost concerns

NEW YORK (Reuters Health) - Even with health insurance, more than one million cancer survivors living in the United States report that they forgo needed medical care because of concerns about cost, according to research presented Wednesday at the American Association for Cancer Research conference on the Science of Health Care Disparities.

"These survivors are either going without, or significantly delaying, dental care, general medical care, mental health care or prescription drugs," Dr. Kathryn Weaver, a cancer prevention fellow at the National Cancer Institute in Bethesda, Maryland, noted in a statement from the conference.

Hispanic and African-American cancer survivors are twice as likely to go without medical care services as non-Hispanic whites.

Although insurance status does play a role, going without care due to cost was noted among those with health insurance. "There are significant out-of-pocket expenses, even for those with insurance," Dr. Weaver pointed out.

She and her colleagues identified 6602 adult cancer survivors, of whom 64.3% were female, 4.8% were Hispanic, 6.4% were non-Hispanic black and 88.8% were non-Hispanic white.

Overall, they found that the prevalence of forgoing medical care due to cost was 7.8% for general medical care, 9.9% for prescription medication, 11.3% for dental care, and 2.7% for mental health care.

The odds ratio for going without prescription medications due to cost concerns was 2.14 for Hispanics and 1.87 for African Americans, compared with non-Hispanic whites. For forgoing dental care, the odds ratio was 2.31 for Hispanics and 1.57 for African Americans.

These differences remained in analyses adjusted for education, health insurance coverage and non-cancer medical co-morbid illnesses.

"Future research needs to examine the impact of forgoing care on survivors' long-term physical and mental well-being and survival," Dr. Weaver and colleagues conclude.

"Clinicians," Dr. Weaver added, "need to be more aware that their patients are not getting these services and work to try to connect them to charity or low-cost care."

Copyright © 2009 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.