Pediatric Cancer Survivors Face Long-Term Financial Challenges

Adult survivors of childhood cancer may experience long-term financial distress related to their battle with the disease, according to a study published in the Journal of the National Cancer Institute.

The study evaluated 2811 pediatric cancer survivors who were enrolled in the St. Jude Lifetime Cohort study, which showed that 65% faced financial problems that stemmed from their initial diagnosis, causing them to skip needed medical care and face psychological distress.

"Advances in treatment and supportive care have increased survival rates for most childhood cancers,” first and corresponding author I-Chan Huang, PhD, associate faculty member, St. Jude Department of Epidemiology and Cancer Control, said in a press release. “By 2020, there will be an estimated 500,000 childhood cancer survivors in the US. "Until now, little was known about the financial hardships that survivors of pediatric cancer face."

The study population ranged in age from 18 to 65 years with an average age of 32 years. The average duration since time of pediatric cancer diagnosis was 23 years. Childhood cancer survivors enrolled in the St. Jude program returned to the hospital periodically for assessments that evaluated self-reported financial resources, level of financial distress, and their coping strategies, according to the press release.

The researchers found that financial problems incurred from health care expenses are prominent among adults who survived cancer during childhood. These challenges include health issues that affect quality of life, which increases the risk of depression and suicide, as well as diminishing the ability to plan for retirement and obtain health and life insurance.

The researchers found that 22.4% of survivors indicate pediatric cancer affected their financial status. Of the patients queried, 51.1% expressed concerns in paying for medical care and 33% indicated that these concerns prevented them from seeking care altogether.

"This analysis suggests the issue is more widespread among pediatric cancer survivors than among survivors who were diagnosed with cancer as adults," Huang said in the press release.

The study showed that the strongest indicators of financial problems are age at the time of diagnosis, as well as education and income level. Those who are aged 40 years and above, did not have a high school degree, or had an annual household income under $40,000 were up to 4 times more likely to experience financial hardship than were survivors who are younger, graduated from college, or had an annual household income of $80,000 or more, according to the study.

The researchers found that chronic health conditions, such as heart attacks and reproductive disorders, and secondary cancers related to treatment were associated with a greater risk of financial distress, including concerns over how to pay for care.

"Severe late effects that emerge early in life and disrupt education and training opportunities are a double hit for survivors. These health problems decrease the survivors' earning mobility and financial security later in life," Huang said in the press release. "The phenomenon leaves them at risk for poor health and psychological outcomes compared to healthier survivors."