This study leverages CDC National Health Interview Survey data to examine Financial Distress (FD) among genitourinary (GU) cancer survivors, specifically prostate cancer (PC), kidney cancer (KC), and bladder cancer (BC). It investigates the economic impacts faced by these patients, especially in relation to disparities in insurance coverage and its effects on material, psychological, and behavioral aspects of FD.
We retrospectively analyzed responses from GU cancer survivors, stratifying by cancer status and age (18-64 years, ≥65 years). Medical financial hardship was divided into three domains: material, psychological, and behavioral. Associations between cancer history, hardship, and clinical factors were assessed using generalized ordinal logistic regressions.
Significant health care access disparities were found, particularly for mental health services, with 25% of younger BC survivors and 4.7% of younger KC survivors reporting affordability issues, in contrast to 2.7% of noncancer individuals. Dental care was also problematic, with higher avoidance rates among younger BC (27%) and KC (15%) survivors compared with the general population. Surprisingly, noncancer individuals reported more difficulty in affording prescriptions than BC survivors across both age groups. PC survivors, however, showed lower FD across all domains versus noncancer controls, indicating fewer concerns about medical bills and a lesser tendency to forgo care.
The study underscores significant gaps in the financial support system for GU cancer survivors, with urgent needs in mental and dental health care access. Policy interventions, including comprehensive insurance reforms, are imperative to alleviate the financial burdens on these individuals.
JCO oncology practice. 2024 Jul 15 [Epub ahead of print]
Steven Leonard, Emma Helstrom, Andres Correa, Mohit Sindhani, Nicole Uzzo, Angela Y Jia, Alexander Kutikov, Robert Uzzo, Sarah P Psutka, Adam Calaway, Zachary Klaassen, Michael Staehler, Marc Smaldone, Christopher J D Wallis, Laura Bukavina
Fox Chase Cancer Center, Philadelphia, PA., India Institute of Technology, Delhi, India., Case Western Reserve School of Medicine, Cleveland, OH., University of Washington Medical Center, Fred Hutchinson Cancer Center, Seattle, WA., Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA., Ludwig-Maximilians University of Munich, Munich, Germany., Division of Urology, University of Toronto, Toronto, ON, Canada.