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. 2019 Jun;13(3):406-417.
doi: 10.1007/s11764-019-00761-1. Epub 2019 May 23.

The social and economic toll of cancer survivorship: a complex web of financial sacrifice

Matthew P Banegas  1 , Jennifer L Schneider  2 , Alison J Firemark  2 , John F Dickerson  2 , Erin E Kent  3   4 , Janet S de Moor  3 , Katherine S Virgo  5 , Gery P Guy Jr  6 , Donatus U Ekwueme  6 , Zhiyuan Zheng  7 , Alexandra M Varga  2 , Lisa A Waiwaiole  2 , Stephanie M Nutt  8 , Aditi Narayan  9 , K Robin Yabroff  10
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The social and economic toll of cancer survivorship: a complex web of financial sacrifice

Matthew P Banegas et al. J Cancer Surviv. 2019 Jun.

Abstract

Purpose: To assess the financial outcomes and associated social and economic effects on cancer survivors and their families.

Methods: We assessed the responses of 1656 cancer survivors to a survey with both closed- and open-ended questions about cancer-related financial sacrifices they and their family experienced and evaluated differences in financial sacrifice by reported levels of cancer-related debt.

Results: The most commonly reported financial sacrifices included cutbacks on household budgets, challenges with health care insurance and costs, career/self-advancement constraints, reduction/depletion of assets, and inability to pay bills. Survivors who incurred $10,000 or more in debt were significantly more likely to report social and economic impacts, including housing concerns and strained relationships.

Conclusions: Our analysis demonstrates both the frequency with which cancer survivors and families must make financial sacrifices as a result of their cancer, and the variety of forms that this sacrifice can take, even for individuals who have health insurance. The many types of financial hardship create challenges that are unique to each survivor and family.

Implications for cancer survivors: Interventions that allow for personalized assistance with the specific financial and social needs of cancer survivors and their families have the potential to address a critical aspect of the long-term wellbeing of this important population.

Keywords: Access to care; Cancer survivors; Financial hardship; Medical debt; Social and economic needs.

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Conflict of interest statement

Conflict of interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Frequency of qualitative domains for financial sacrifice open-ended responses (n = 1656). Notes: Information presented includes the 18 financial sacrifice domains coded from the open-ended qualitative data of the 1656 respondents, and the number of times each financial sacrifice was mentioned (e.g., instances) in participant responses. A domain (i.e., reduction/depletion of assets) could have more than one instance coded for each participant when reflecting specific sub-codes within that domain (i.e., “sold major asset like house or car” or “depleted savings account”)
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