Affiliation:
1. 1Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
2. 2Population Informatics Lab, Texas A&M University, College Station, Texas.
3. 3Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi.
4. 4Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
5. 5Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
6. 6Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas.
7. 7Division of Cancer Prevention and Population Science, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
This study estimates the out-of-pocket (OOP) expenditures for different cancer types among survivors with current versus no current cancer condition and across sex, which is understudied in the literature. This is a cross-sectional study of Medical Expenditure Panel Survey data for 2009–2018 where the primary outcome was the average per year OOP expenditure incurred by cancer survivors. Of 189,285 respondents, 15,010 (7.93%) were cancer survivors; among them, 46.28% had a current cancer condition. Average per year OOP expenditure for female survivors with a current condition of breast cancer ($1,730), lung cancer ($1,679), colon cancer ($1,595), melanoma ($1,783), non–Hodgkin lymphoma ($1,656), nonmelanoma/other skin cancer (NMSC, $2,118) and two or more cancers ($2,310) were significantly higher than that of women with no history of cancer ($853, all P < 0.05). Similarly, average per year OOP expenditure for male survivors with a current condition of prostate cancer ($1,457), lung cancer ($1,131), colon cancer ($1,471), melanoma ($1,474), non–Hodgkin lymphoma ($1,653), NMSC ($1,789), and bladder cancer ($2,157) were significantly higher compared with the men with no history of cancer ($621, all P < 0.05). These differences persisted in survivors with no current cancer condition for breast cancer among women; prostate, lung, colon, and bladder cancer among men; and melanoma, NMSC, and two or more cancers among both sexes. OOP expenditure varied across cancer types and by sex for survivors with and without a current cancer condition. These findings highlight the need for targeted interventions for cancer survivors.
Significance:
Our study found that OOP expenditures among survivors with a current cancer condition for several cancers were significantly higher than that of individuals without a cancer history. These differences persisted in female with breast cancer; male with prostate, lung, colon, and bladder cancer; and survivors of both sexes with melanoma, and NMSC/other skin cancer, even after there was no current cancer condition.
Funder
HHS | NIH | National Cancer Institute
Duncan Family Institute for Cancer Prevention and Risk Assessment
Cancer Prevention and Research Institute of Texas
Betty B. Marcus Chair in Cancer Prevention
Publisher
American Association for Cancer Research (AACR)
Reference55 articles.
1. Cancer statistics, 2021.;Siegel;CA Cancer J Clin,2021
2. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience;Zafar;Oncologist,2013
3. The financial burden and distress of patients with cancer: understanding and stepping-up action on the financial toxicity of cancer treatment;Carrera;CA Cancer J Clin,2018
4. Out-of-pocket costs, financial distress, and underinsurance in cancer care;Chino;JAMA Oncol,2017
5. Health services utilization, out-of-pocket expenditure, and underinsurance among insured non-elderly cancer survivors in the United States, 2011–2015;Karim;Cancer Med,2021