Young Cancer Survivors Most Vulnerable to Financial Hardships


Younger cancer survivors and those with high deductible private insurance plans experienced the greatest financial burden.

Cancer survivors undoubtedly face a greater financial burden than those without a history of the disease. A new study indicates that younger cancer survivors are most vulnerable to financial hardship, as well as those enrolled in high deductible health plans without health savings accounts.

The study, published in CANCER, encompassed financial hardship related to medical bills and debt payments experienced by individuals with a history of cancer compared with those who have never had cancer. The researchers analyzed information from the 2013 to 2016 National Health Interview Survey of 10,354 cancer survivors and 124,436 individuals without a history of cancer. Medical financial hardship included material, psychological, and behavioral burdens.

According to the study, 43.3% of cancer survivors were more likely to report material hardship, 53.5% psychological hardship, and 30.6% behavioral hardship, compared with 30.1%, 27.8%, and 47.1% in those without a cancer history, respectively. Privately-insured cancer survivors with high deductible health plans without a health savings account were also more likely to experience greater hardship compared with low deductible insurance.

The study also showed that younger cancer survivors between the ages of 18 and 49 years old especially had greater financial hardship. Possible contributors may be diminished opportunity to accumulate financial assets to pay for medical expenses and interruption in employment, according to the researchers.

These findings build on previous research that asserted the lasting financial hardship of cancer. A previous study published in the Journal of Supportive Care and Cancer assessed the cumulative economic toll that breast cancer has on survivors and family members, indicating that the economic burden of treatment can affect mental health and result in negative health outcomes.

Another study also found a long-term financial burden among adult survivors of childhood cancer. In addition to the added medical expenses of their cancer, chronic conditions related to treatment can also be a contributing financial stressor long after the cancer is gone.

According to the researchers, the findings suggest that interventions should consider multiple domains of financial hardship, as well as insurance benefit design.

“Identifying patients with medical financial hardship will be important for primary care and oncology care providers,” study author Zhiyuan Zheng, PhD, of the American Cancer Society, said in a press release. “Developing and evaluating interventions to minimize medical financial hardship will be important for the research community. It may also require attention from health policy maker.”


Zheng Z, Jemal A, Han X, et al. Medical financial hardship among cancer survivors in the United States. Cancer. 2019.

Cancer Survivors Face Significant Hardship Related to Medical Bills [news release]. Wiley’s website. Accessed January 21, 2019.

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