Cancer survivors face substantial financial burdens, US report says

People who survive cancer face significant financial burdens from higher medical costs and lost productivity due to disability and illness, says an analysis in the US Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.1

An estimated 13.4 million people (4.6%) in the United States are cancer survivors. Over the next decade, due to improvements in cancer detection and care, that number is expected to increase by more than 30% to 18 million. About half of cancer survivors are of working age.

Using data collected from 2008 to 2011 by the Medical Expenditure Panel Survey—a nationally representative survey conducted each year—the researchers found that men with a history of cancer had an average annual medical expenditure of $8091 (£4770; €5965), compared with an average of $3904 among those without a history of cancer. Among women with a history of cancer the average annual expenditure was $8412, compared with $5119 for those with no history of cancer.

The estimates were adjusted for a variety of factors including age, race and ethnicity, marital status, and other medical conditions, such as diabetes, respiratory disorders, and coronary heart disease. The researchers included all cancer diagnoses except non-melanoma skin cancer.

The cost of lost productivity was also substantial. Among men with a history of cancer, researchers estimated an average $3710 annual loss in productivity, compared with $2260 among men with no history of cancer. Among females who had a history of cancer the average was $4033, compared with $2700 among females who did not.

About one in three survivors reported that they were disabled and unable to return to work or that they had a decreased ability to work because of limitations from mental and physical functioning and psychological stress. Employment disability accounted for about 75% of lost productivity among both groups, the researchers found.

“Among cancer survivors who were employed at any time since diagnosis, cancer and its treatment interfered with physical tasks (25%) and mental tasks (14%) required by the job, with nearly 25% of cancer survivors feeling less productive at work,” they wrote. Nearly a third of survivors reported that cancer and the effects of treatment also interfered with their daily activities outside work.

The researchers noted that their study had a number of limitations, including its reliance on self reported cancer diagnosis and a survey response rate of less than 60%, which they said might reflect a non-response bias. The survey also captured only part of the economic burden linked to cancer survival, the researchers noted, and so the results did not reflect costs arising from time spent receiving medical care or lost productivity among caregivers.

The researchers concluded, “The economic data presented in this report investigating the economic consequences of surviving cancer highlight the need to develop comprehensive intervention programs to improve the quality of the cancer survivorship experience and decrease the economic burden of cancer survivorship in the United States.”

The report was prepared by a newly established collaborative group, the Health Economics Research on Cancer Workgroup, which comprised researchers from the US Centers for Disease Control and Prevention, the National Cancer Institute, the Agency for Healthcare Research and Quality, the American Cancer Society, Emory University, and the Livestrong Foundation.