Cancer Patients with a History of Adverse Financial Events More Apt to Be Diagnosed at Later Stage

A patient’s finances can impact cancer outcomes, with research showing that low income cancer survivors have worse mental and physical health and that people from lower income counties have a higher risk of dying within five years of diagnosis than those from higher income counties. A new study finds that serious financial events that occurred before diagnosis may also impact a patient’s outcomes.

Recent research from the American Cancer Society and the National Cancer Institute investigated how adverse financial events like bankruptcies, liens, and evictions impacted when a person was diagnosed with cancer. The findings, published in the Journal of Clinical Oncology, showed that cancer patients with such a financial history were more apt to be diagnosed at a later stage than people with less financial stress. These events also often happened years before diagnosis.

Woman stresses over bills

Dr. Robin Yabroff, senior author and scientific vice president of health services research at the American Cancer Society, says, “Patients with a previous [adverse financial event] not only face greater likelihood of more advanced cancer but also may encounter substantial barriers to receiving recommended care and experience worse health outcomes for their newly diagnosed cancer because of their pre-existing financial vulnerability.”

To better understand how these financial incidents may impact cancer diagnosis, the researchers looked at data on adults aged 20 through 69 who were diagnosed with cancer between 2014 and 2015 through the Seattle, Louisiana, and Georgia SEER population-based cancer registries. They also looked at consumer data from LexisNexis to determine if the patients had experienced a court documented adverse financial event prior to their diagnosis.

Nearly 102,000 patients had data on LexisNexis. Of them, just under 37,000 had an adverse financial event prior to diagnosis. On average, these occurred 7.5 years beforehand. They were most common in non-Hispanic Black patients, who already face cancer outcome disparities, as well as in unmarried patients and those with lower incomes. People with such a financial history were more apt to be diagnosed at stage III or IV than those without a history of these financial events. This was true even after adjusting for possible contributing factors.

Woman holds calculator while looking at bills

The researchers say this shows that many patients are already dealing with financial issues before incurring the financial headaches associated with cancer diagnosis and treatment.

Dr. Yabroff says, “Understanding patients’ financial vulnerability within healthcare settings may inform efforts to improve equitable access to oncology care.”

The National Cancer Institute notes that cancer patients and survivors are also more apt to face financial distress due to their medical bills, which can then lead to more adverse financial events. The agency says there are ongoing studies on possible ways to help address this. Those include having patients meet with financial navigators to learn about health insurance plans and cost-saving options available to them, hospitals posting their prices so that doctors and patients know what treatments will cost, introducing value-based pricing, and reforming health insurance by passing policies that help people with cancer. If you’d like to learn more about financial distress and cancer patients, click here.

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