Bottom Line: Young women with breast cancer experienced substantial financial difficulties in the wake of a breast cancer diagnosis, even if they had stable jobs with insurance benefits.
Journal in Which the Study was Published: Cancer Epidemiology, Biomarkers & Prevention , a journal of the American Association for Cancer Research
Author: Florence K.L. Tangka, PhD, MS, a health economist in the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention (CDC) in Atlanta.
Background: The majority of young women treated for breast cancer are in the early stages of building their careers and raising families, so the burden of a cancer diagnosis can be significant.
How the Study was Conducted: In this study, researchers identified women between the ages of 18 and 39 who had received a breast cancer diagnosis from January 2013 to December 2014, drawing from state cancer registries in California, Florida, Georgia, and North Carolina. They chose these states because they had relatively large numbers of young breast cancer patients across all major racial/ethnic groups, Tangka said.
The researchers developed a survey with questions on insurance status, including changes in coverage; out-of-pocket costs related to their cancer care; employment status and benefits such as sick leave and scheduling flexibility; and access to treatment and quality of care. In total, 830 women completed the survey.
Results: Almost half the women--47 percent--experienced financial decline due to costs related to their cancer care. Some key findings on their employment and financial status:
Author's Comments: Tangka said the results of the study indicate that many women who are diagnosed with breast cancer in the early years of their careers try to maintain their jobs in order to keep their health insurance coverage, and despite having insurance coverage, they may still experience financial challenges through the course of treatment.
Tangka added that while employment benefits varied, programs like paid sick leave, flexible scheduling, disability leave, and telecommuting often helped women maintain their employment status. She said future research could examine additional employment modifications, such as increasing part-time options.
Tangka added that a greater understanding of the costs of cancer care could help inform some women's treatment decisions.
"A lot of women don't have a good sense of how much a cancer diagnosis will cost, including out-of- pocket costs," she said. "We feel that if they have cost information, they can develop better financial plans to cover their treatment expenses."
She said the study data could serve as a reminder to clinicians that financial concerns can be considered when discussing treatment.
"Even though patients and physicians understand the importance of having discussions about the economic burden of cancer, such conversations seldom occur," Tangka said. "Cancer patients may not have choices in all aspects of cancer care, but if they have information on the duration of treatment and how much they need to pay out of pocket, they can plan better."
Study Limitations: Tangka noted that because the study included data from four states, the results may not be generalizable nationwide. Also, she said economically disadvantaged or sicker women may have been less likely to respond to the survey.
Funding & Disclosures: This study was funded by the CDC. Tangka declares no conflicts of interest.
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Cancer Epidemiology