Medical Debt Linked to More Late-Stage Lung and Other Cancers

People living in U.S. counties with more medical debt were more likely to be diagnosed with several cancers at a late stage, according to a study published in the October 2026 issue of JAMA Network Open. The link was strongest for lung cancer.

The study looked at counties, not individual people, so it shows an association, not that medical debt causes late diagnoses. But it adds to evidence that money problems tied to health care can stand between people and timely cancer care.

What the Study Looked At

Researchers, including scientists from the American Cancer Society, studied 2,958 U.S. counties. They compared the share of residents in each county who had medical debt in collections in 2016, meaning medical bills long past due and sent to a collections department, with county cancer rates from 2017 to 2021 for nine cancer types.

They focused on late-stage cancers, meaning cancers that had spread to nearby tissue or lymph nodes (regional) or to distant parts of the body (distant) at diagnosis. The analysis took into account whether a county was urban or rural, its social vulnerability, the number of primary care doctors and differences between states.

What It Found

On average, 21.1% of county residents had medical debt in collections, ranging from 1.2% to 51.8% across counties. Medical debt was more common in rural counties (21.5%) than urban ones (20.5%), and in the most socially vulnerable counties (27.4%) than the least vulnerable (13.9%).

For every 10-percentage-point rise in a county's medical debt, the study found more late-stage diagnoses per 100,000 people each year:

• Lung cancer: 5.15 more cases
• Head and neck cancer: 0.92 more
• Colorectal cancer: 0.69 more
• Melanoma: 0.59 more
• Cervical cancer: 0.39 more
• Kidney cancer: 0.38 more
• Bladder cancer: 0.24 more

Overall cancer rates followed similar patterns. Late-stage breast cancer did not show a clear link in the main analysis. Late-stage prostate cancer was actually lower in high-debt counties, which the researchers said may reflect less screening and testing in those areas rather than less disease.

The authors wrote that medical debt may reflect "structural and financial barriers" to cancer diagnosis and care.

What's Still Unknown

Because the study compared counties, it cannot show that the people with medical debt were the same people diagnosed with late-stage cancer. Other factors, such as income, access to care and smoking, may partly explain the link. The debt data were from 2016, before recent changes in how medical debt shows up on credit reports. The study also did not test whether reducing medical debt would lead to earlier diagnoses.

What It Means for You

Worry about bills is a common reason people put off checkups, screening or getting a new symptom looked at. Many screening tests, including mammograms, colorectal cancer screening and lung cancer screening for those who qualify, are covered with no out-of-pocket cost by Medicare and most private plans. Hospitals also have financial assistance programs, and many cancer centers have financial navigators who help patients sort out costs. CURE has reported on how medical debt affects people with cancer.

If you have a symptom that isn't going away, such as a cough that lasts for weeks, a change in bowel habits or a sore that won't heal, don't let cost keep you from getting it checked.

References

1. "Medical Debt and Advanced Cancer Stage at Diagnosis." Xing J, et al. JAMA Network Open. October 2026.

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