Cost of cancer care impacts health of low-income survivors

The cost of cancer treatment negatively impacts the physical and mental health of survivors who are living in poverty, according to a recent study co-authored by Lovoria Williams, Ph.D., University of Kentucky Markey Cancer Center’s associate director of Cancer Health Equity, Diversity and Inclusion.

The results of the study published in JCO Oncology Practice Sept. 6 provide important information about the impact of social determinants of health on low-income cancer survivors, which highlights the urgent need to implement strategies to improve health policy.

Williams, an associate professor in UK’s College of Nursing and Sally Humphrey Endowed Research Professor in Cancer Health Equity, collaborated with a multidisciplinary team of researchers from the Medical College of Georgia and the Georgia Cancer Center at Augusta University, including the study’s senior author Georgia Cancer Center Director Jorge Cortes, M.D.

Using data from the Centers for Disease Control and Prevention’s 2020 Behavioral Risk Factor Surveillance System (BRFSS), the team examined characteristics of cancer survivors living in poverty in the U.S., including their physical and mental health.

Cancer survivors living in poverty were twice as likely to have worse self-reported health and a greater number of days when their physical and mental health was not good. In addition, cancer survivors living in poverty were less likely to have health insurance coverage and more likely to not see a doctor because of cost. Moreover, the findings indicate disparate financial impact among racial and ethnic minorities and younger survivors, further exacerbating cancer health inequities.

“To improve the cancer survivorship experience and caregiver distress, proactive approaches to mitigate financial toxicity are imperative,” Williams said. “Our findings have important policy implications, and it provides data that support the role of financial navigators as integral members of comprehensive cancer care teams.”

Financial toxicity is a term used to describe cancer-related financial hardship: the impact of out-of-pocket expenses and emotional distress caused by the cost of cancer care and treatment. This financial distress may deter patients with cancer from seeking follow-up care.

“This is especially true for racial and ethnic minorities and low-income individuals. Women, younger cancer survivors, and those who are uninsured are also more likely to experience financial toxicity,” the study reports.

Interventions for reducing financial hardship among cancer survivors include cost transparency and financial navigators in health care settings, as well as policy interventions to reform employment protection and health insurance programs.