Long-Term Financial Burden of Breast Cancer: Experiences of a Diverse Cohort of Survivors Identified Through Population-Based Registries

Authors

Reshma Jagsi, University of MichiganFollow
John A.E. Pottow, University of Michigan Law SchoolFollow
Kent A. Griffith, University of Michigan
Cathy Bradley, Virginia Commonwealth University
Ann S. Hamilton, Unversity of Southern California
John Graff Rutgers University
Steven J. Katz, University of Michigan
Sarah T. Hawley, University of MichiganFollow

Document Type

Article

Publication Date

4-2014

Abstract

Purpose: To evaluate the financial experiences of a racially and ethnically diverse cohort of long-term breast cancer survivors (17% African American, 40% Latina) identified through population-based registries. Methods: Longitudinal study of women diagnosed with nonmetastatic breast cancer in 2005 to 2007 and reported to the SEER registries of metropolitan Los Angeles and Detroit. We surveyed 3,133 women approximately 9 months after diagnosis and 4 years later. Multivariable models evaluated correlates of self-reported decline in financial status attributed to breast cancer and of experiencing at least one type of privation (economically motivated treatment nonadherence and broader hardships related to medical expenses). Results: Among 1,502 patients responding to both surveys, median out-of-pocket expenses were less than or equal to $2,000; 17% of respondents reported spending > $5,000; 12% reported having medical debt 4 years postdiagnosis. Debt varied significantly by race: 9% of whites, 15% of blacks, 17% of English-speaking Latinas, and 10% of Spanish-speaking Latinas reported debt ( P = .03). Overall, 25% of women experienced financial decline at least partly attributed to breast cancer; Spanish-speaking Latinas had significantly increased odds of this decline relative to whites (odds ratio [OR], 2.76; P = .006). At least one privation was experienced by 18% of the sample; blacks (OR, 2.6; P < .001) and English-speaking Latinas (OR, 2.2; P = .02) were significantly more likely to have experienced privation than whites. Conclusion: Racial and ethnic minority patients appear most vulnerable to privations and financial decline attributable to breast cancer, even after adjustment for income, education, and employment. These findings should motivate efforts to control costs and ensure communication between patients and providers regarding financial distress, particularly for vulnerable subgroups.

Comments

Also available on the journal website.

Recommended Citation

Jagsi, Reshma, co-author. "Long-Term Financial Burden of Breast Cancer: Experiences of a Diverse Cohort of Survivors Identified Through Population-Based Registries." J. A. E. Pottow et al., co-authors. J. Clin. Oncology 32, no. 12 (2014): 1269-76.