Cancer survivors in the United States who reported medical financial difficulties had a higher mortality risk than cancer survivors who did not report financial hardship, according to new findings from a major national survey.

Medical financial hardship was defined as having difficulty affording health care or postponing or foregoing any health care in the previous 12 months owing to cost.

The research was published in the National Cancer Institute’s Journal today (JNCI).

According to the lead author of the study Dr. Robin Yabroff, “Cancer survivors frequently experience medical financial hardship, however, little research has examined its associations with long-term health consequences.”

“Our findings show the need to address financial hardship to ensure that cancer survivors do not delay or forgo necessary care because they cannot afford it.”

Researchers used data from the 1997-2014 National Health Interview Survey (NHIS) and NHIS Linked Mortality Files through 2015 to identify more than 25,000 cancer survivors for this investigation.

Because of age-eligibility, nearly all persons aged 65 and older got health insurance coverage through Medicare. Adults under the age of 65 who were experiencing financial difficulties were less likely to have private health insurance and were more likely to be uninsured.

In adjusted analyses, survivors in both age groups who experienced financial difficulties had a greater adjusted mortality risk than those who did not. Further adjusting for health insurance coverage lowered the severity of the link between hardship and mortality among survivors under the age of 65, while supplemental Medicare coverage had no effect on survivors 65 and older.

“Our findings underscore the protective effects of Medicare coverage and highlight the importance of comprehensive health insurance coverage in mitigating financial hardship for cancer survivors under 65,” added Yabroff. “Efforts to address financial hardship as part of oncology practice and survivorship care are needed.”

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