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Financial Burden of Breast Cancer More Difficult for Black Women

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The costs associated with breast cancer treatment and follow-up care can be a financial strain for some people and their families, even with health insurance.

Besides the costs of treatments such as surgery or radiation, you may be facing extra expenses for transportation to and from a treatment center, child care while you're having treatment, or special foods to make sure your nutritional needs are being met. If you've had to take time off from work and your income is lower, these daily living expenses can be challenging to cover.

Many studies have found that compared to white women, Black women have worse outcomes after being diagnosed with breast cancer. While research suggests that this is due in part to the different biology of breast cancer in Black women, researchers wondered if Black women faced different or worse financial problems after being diagnosed with breast cancer and if these problems may contribute to the difference in outcomes.

An analysis of data from the Carolina Breast Cancer Study strongly suggests that Black women diagnosed with breast cancer have more financial problems than white women diagnosed with breast cancer.

The research was published online on April 18, 2018 by the Journal of Clinical Oncology. Read the abstract of “Financial Impact of Breast Cancer in Black Versus White Women.”

"Financial hardship plays a role in delays, discontinuation, and omission of treatment, and thus may correlate with racial disparities in breast cancer death," said Stephanie Wheeler, the study's lead author and associate professor in the Gillings School of Global Public Health at the University of North Carolina. "With cancer care costs rapidly increasing, culturally appropriate strategies are urgently needed to address this problem."

Started in 1993, the Carolina Breast Cancer Study aims to improve the understanding of breast cancer, particularly why breast cancer mortality is higher in Black women. The study is in its third phase, which is focusing on how treatment decisions, access to care, and financial or geographic barriers affect breast cancer outcomes.

The women in the study provided their medical records, as well as information on their demographics, socioeconomic status, and the financial effects of breast cancer, 5 months and 25 months after being diagnosed.

To do this study, the researchers analyzed the financial information from 2,494 women:

  • 1,229 women were Black (49%)
  • 1,265 women were white (51%)

On average, compared to white women, Black women in the study were:

  • slightly younger
  • diagnosed with higher stage breast cancer
  • more likely to be treated with chemotherapy and radiation
  • more likely to have other health conditions, such as obesity, high blood pressure, and diabetes
  • more likely to have lower average income
  • more likely to be uninsured

Overall, nearly half of the women -- 48% -- said that breast cancer caused financial problems for them. Still, Black women were much more likely than white women to have financial problems caused by breast cancer:

  • 58% of Black women said breast cancer caused financial problems
  • 39% of white women said breast cancer caused financial problems

Compared to white women diagnosed with breast cancer, Black women diagnosed with breast cancer were more likely to have:

  • lost private insurance
  • lost a job
  • had financial problems cause them to delay or refuse recommended treatment
  • had transportation problems cause them to delay or refuse recommended treatment

Even after the researchers took into account the differences in age, stage at diagnosis, other health conditions, and treatments received, Black women were still much more likely to have more financial problems because of breast cancer than white women.

“Prevalence of adverse financial impact of cancer is high among all breast cancer survivors, and Black women experience a disproportionate share of this burden,” the researchers wrote. “Overall, the study found that adverse financial impact is reported by more than one half of Black women and more than one third of white women, a large proportion of which is attributable to lost income postdiagnosis. Disproportionate financial strain may contribute to higher stress, lower treatment compliance, and worse outcomes by race. Policies that help to limit the effect of cancer-related financial strain are needed.”

If you don't have insurance or are unemployed, paying for treatment may seem overwhelming. Don't panic and don't skip any treatments or doctor's visits. There ARE resources available to help you.

Someone at your doctor’s office may be able to give you a list of organizations that offer financial assistance for breast cancer medicines and care, as well as local organizations that offer financial assistance for your practical needs such as transportation, food, and child care. Many pharmaceutical companies have set up special funds to help pay for the cost of their medicines.

For lists of resources and tips to lower medicine costs, visit the Paying for Your Care pages.

In our Employment, Insurance, and Other Financial Issues Discussion Board forum, you can get advice from other women who have dealt with financial issues related to breast cancer.

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