Financial Worry and Food Insecurity Is High Among Younger Cancer Survivors

Financial toxicity is a lasting effect of cancer and its treatment for most patients and survivors. But younger survivors face an even bigger burden when it comes to paying for necessary living expenses, such as food, housing and monthly bills, according to study findings published in the Journal of the National Comprehensive Cancer Network.

“For individual patients, they are facing to choose between medical care and sometimes withdrawing savings, selling their house or buying food to mitigate financial hardship from medical treatments,” lead researcher Zhiyuan Zheng, a health economist and principal scientist in the Surveillance and Health Services Program at the American Cancer Society, said in an interview with CURE®.

Zheng and a team of researchers from UCLA and The Center for Health Research at Kaiser Permanente used the 2013-2017 National Health Interview Survey to identify 12,141 cancer survivors (771 age 18-39; 4,269 age 40-64; and 7,101 age 65 and older) and 143,664 individuals without a cancer history (53,262 age 18-29; 60,141 age 40-64; and 30,261 age 65 and older).

Financial concerns were put into categories related to retirement, standard of living, monthly bills and housing costs. Participants could respond “very worried”, “moderately worried”, “not too worried” and “not worried at all.” A point system was tied to the responses. In addition, food insecurity was also ranked with responses of “worry about food running out”, “food not lasting” and “unable to afford balanced meals.”

Compared with individuals without cancer, the researchers found that survivors age 18-39 had severe financial worry (26.4%). For example, 20.4% reported high levels of worry about paying monthly bills compared with 12.9% of people without a history of the disease.

Severe food insecurity was also a concern for younger survivors with 12.6% reporting worry. For 6.3% of survivors, affording balanced meals was a concern compared with 3.4% people who never had cancer.

“Part of the reason younger generations are affected is because they don’t have a lot of savings set aside,” Zheng said. “They might also have other obligations, such as children or helping parents.”

He added that disruptions at work could also be a factor. For instance, they may not have paid sick leave and they fear they may lose their job and potentially insurance.

In the 40-64 age group, 22.2% reported severe financial worry and 6.9% of those 65 and older. Severe food insecurity was a concern for 6.8% in the 40-64-year-old group and 2.3% of those in the 65 and older group.

Among the three age groups, lower income and higher comorbidities were associated with greater financial worry and food insecurity. However, the researchers noted that because the information was self-reported there could be bias; therefore, creating limitations to the study.

“Cancer survivors need to talk to with their physicians and they should be able to let them know what the medical cost looks like in the future,” Zheng said.

The Deferment for Active Cancer Treatment Act of 2018 currently helps some survivors as it allows patients with cancer to postpone payments on public student loans while they are in treatment. Also, Medicare & Medicaid Services expanded Medicare Advantage coverage to allow insurers to include healthy groceries, rides to medical appointments and home delivered meals for young patients with disabilities who qualify.