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Many Young Women Have Financial Problems After Breast Cancer Diagnosis, Even With Insurance

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Many women younger than 40 who are diagnosed with breast cancer have money problems after being diagnosed, even if they have stable jobs with health insurance benefits, according to a study.

The research was published in the journal Cancer Epidemiology, Biomarkers & Prevention on March 4, 2020. Read the abstract of “Insurance Coverage, Employment Status, and Financial Well-Being of Young Women Diagnosed with Breast Cancer.”

The results offer more evidence that the costs of breast cancer treatment and follow-up care can be a financial strain for a number of people and their families, even with health insurance. Besides the cost of treatment itself, people also may be facing extra expenses for travelling to and from a treatment center, child care during treatment, or lower income from taking time off work.

How the study was done

The researchers analyzed survey responses from 830 women who had been diagnosed with DCIS (non-invasive breast cancer) or invasive breast cancer between January 2013 and December 2014. All the women were between the ages of 18 and 39 when diagnosed.

The women lived in California, Florida, Georgia, and North Carolina. The researchers chose those states because they have large numbers of racially and ethnically diverse young women diagnosed with breast cancer.

The survey asked about:

  • insurance coverage
  • out-of-pocket expenses
  • cancer-related expenses
  • any financial issues
  • employment status
  • employment benefits
  • access to breast cancer treatment
  • quality of breast cancer care
  • symptoms
  • cancer history
  • other health conditions

Of the 830 women:

  • 48.1% were white
  • 17.9% were Black
  • 23.9% were Hispanic
  • 5.3% were Asian/Pacific Islander
  • 60.5% were 35 to 39 years old
  • 57.4% had earned a bachelor’s or master’s degree
  • 71.1% were married or in a domestic partnership
  • 31.5% were diagnosed with DCIS or stage I breast cancer
  • 35.4% were diagnosed with stage II breast cancer
  • 21.4% were diagnosed with stage III breast cancer
  • 6.9% were diagnosed with stage IV breast cancer
  • 95.2% had surgery
  • 76.7% had chemotherapy
  • 62.8% had radiation therapy
  • 62.1% took hormonal therapy

The results: Nearly half had financial problems

The survey results showed that nearly half the women — 47% — had money issues because of costs related to cancer care.

More than one-third of the women paid more than $2,000 in out-of-pocket costs for cancer care:

  • 17% spent $5,001–$10,000
  • 18.7% spent $2,001–$5,000
  • 27.9% spent $500–$2,000
  • 27.7% spent less than $500

More than 80% of the women used personal funds to pay these out-of-pocket costs:

  • 81.5% used personal funds
  • 22.9% borrowed money from family or friends
  • 22.7% didn’t pay some medical bills
  • 21.7% increased their credit card debt
  • 18.2% postponed paying bills

Many women said that the cancer diagnosis affected their jobs:

  • 40.4% said their job performance had suffered
  • 12.2% said they quit their jobs
  • 7.5% said they lost their jobs
  • 23.5% said they avoided changing jobs to keep their health insurance
  • 55% took paid time off during treatment
  • 47.3% took unpaid time off during treatment

Overall, women without a college degree were more likely to have financial problems. Women diagnosed with stage III or stage IV breast cancer were the most likely to have financial problems.

“Although most young patients with breast cancer were insured,” the researchers wrote, “one in 10 reported paying more than expected for health insurance during the 12-month period prior to the survey, and a smaller percentage lost coverage, could not afford insurance, or were denied coverage.”

“A lot of women don't have a good sense of how much a cancer diagnosis will cost, including out-of-pocket costs,” said lead author Florence Tangka, health economist in the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention. “We feel that if they have cost information, they can develop better financial plans to cover their treatment expenses.”

She said the study results could help remind doctors that financial concerns should be considered when discussing treatment.

“Even though patients and physicians understand the importance of having discussions about the economic burden of cancer, such conversations seldom occur,” Tangka said. “Cancer patients may not have choices in all aspects of cancer care, but if they have information on the duration of treatment and how much they need to pay out of pocket, they can plan better.”

Financial resources are available

If the thought of paying for breast cancer treatment and follow-up care seems overwhelming, know that resources are available to help you. Don’t panic, and don’t skip any treatments or doctor visits.

Many doctors keep lists of organizations that offer financial assistance for breast cancer medicines and care, as well as local organizations that offer financial assistance for 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 much more information and links to resources, visit the Breastcancer.org Paying for Your Care pages.

Discuss your financial concerns with others in the Breastcancer.org Discussion Board forum Employment, Insurance, and Other Financial Issues.

Written by: Jamie DePolo, senior editor

Reviewed by: Brian Wojciechowski, M.D., medical adviser


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