PCN179 TEN-YEAR TREND IN CLINICAL PREVENTIVE SERVICES AND SELF-MANAGEMENTAMONG ADULT CANCER SURVIVORS IN THE UNITED STATES

1560 Background: Rising costs of cancer care have imposed substantial financial burden on cancer survivors. To date, little is known about the associations between potentially modifiable patient characteristics, including health insurance literacy (HIL), on financial burden among cancer survivors. This study aimed to evaluate the associations between HIL and financial hardship and financial sacrifices among adult cancer survivors in the United States. Methods: We identified 914 adult cancer survivors from the 2016 Medical Expenditure Panel Survey Experiences with Cancer Questionnaire. HIL was measured based on the question “Did you ever have a problem understanding health insurance or medical bills related to your cancer, its treatment, or the lasting effects of that treatment?” Medical financial hardship was measured in three domains—1) material (e.g. problems paying medical bills); 2) psychological (e.g. worry about large medical bills); and 3) behavioral (e.g. delay or forego healthcare because of cost). Financial sacrifices were based on questions related to changes in spending on vacation or leisure activities. We used multivariable logistic regression modeling to separately evaluate the associations between HIL problems and 1) financial hardship and 2) financial sacrifices. Results: 18.9% cancer survivors aged 18-64 years and 14.6% survivors ≥65 years reported HIL problems. Regardless of age groups, cancer survivors with HIL problems were more likely to report any material (OR =3.2; 95% CI:1.9-5.2) or psychological (OR=7.2; 95% CI: 4.1-12.7) financial hardship than those without the problems, as well as more likely to delay or forgo multiple medical care due to cost, including prescription medicine (OR=3.6; 95% CI: 1.8-7.1), specialist visit (OR=2.6; 95% CI: 1.2-5.8), and follow-up care (OR=2.1, 95% CI 1.2-4.0). Higher likelihood of reporting all measures of financial sacrifices were observed among those with HIL problems in both age groups (all p<0.05). Conclusions: Cancer survivors with HIL problems were more likely to report financial hardship and financial sacrifices than those without the problems. Improving HIL may help mitigate financial hardship.

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Abstract D099: Excess burden of major cancer risk factors in racial/ethnic minority adult cancer survivors in the United States (2005–2016)

10.1158/1538-7755.disp19-d099 ◽

2020 ◽

Author(s):

Chinenye C Ugoji ◽

Lorraine T Dean ◽

Elizabeth A Platz

Keyword(s):

United States ◽

Risk Factors ◽

Cancer Risk ◽

Cancer Survivors ◽

Ethnic Minority ◽

The United States ◽

Cancer Risk Factors ◽

Excess Burden ◽

Adult Cancer Survivors ◽

Racial Ethnic

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Secondhand Smoke Exposure Among Community-Dwelling Adult Cancer Survivors in the United States: 1999–2012

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-16-0777 ◽

2017 ◽

Vol 26 (8) ◽

pp. 1296-1305 ◽

Cited By ~ 2

Author(s):

Oladimeji Akinboro ◽

Odunayo Olorunfemi ◽

Prasanta Basak ◽

Elizabeth Phillips ◽

Daniel Pomerantz ◽

...

Keyword(s):

United States ◽

Cancer Survivors ◽

Secondhand Smoke ◽

The United States ◽

Smoke Exposure ◽

Community Dwelling ◽

Secondhand Smoke Exposure ◽

Adult Cancer Survivors

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Financial Hardship Associated With Cancer in the United States: Findings From a Population-Based Sample of Adult Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2015.62.0468 ◽

2016 ◽

Vol 34 (3) ◽

pp. 259-267 ◽

Cited By ~ 177

Author(s):

K. Robin Yabroff ◽

Emily C. Dowling ◽

Gery P. Guy ◽

Matthew P. Banegas ◽

Amy Davidoff ◽

...

Keyword(s):

United States ◽

Cancer Survivors ◽

Family Income ◽

Medical Expenditure Panel Survey ◽

The United States ◽

Population Based ◽

Financial Hardship ◽

Medical Expenditure ◽

Logistic Regression Models ◽

Adult Cancer Survivors

Purpose To estimate the prevalence of financial hardship associated with cancer in the United States and identify characteristics of cancer survivors associated with financial hardship. Methods We identified 1,202 adult cancer survivors diagnosed or treated at ≥ 18 years of age from the 2011 Medical Expenditure Panel Survey Experiences With Cancer questionnaire. Material financial hardship was measured by ever (1) borrowing money or going into debt, (2) filing for bankruptcy, (3) being unable to cover one’s share of medical care costs, or (4) making other financial sacrifices because of cancer, its treatment, and lasting effects of treatment. Psychological financial hardship was measured as ever worrying about paying large medical bills. We examined factors associated with any material or psychological financial hardship using separate multivariable logistic regression models stratified by age group (18 to 64 and ≥ 65 years). Results Material financial hardship was more common in cancer survivors age 18 to 64 years than in those ≥ 65 years of age (28.4% v 13.8%; P < .001), as was psychological financial hardship (31.9% v 14.7%, P < .001). In adjusted analyses, cancer survivors age 18 to 64 years who were younger, female, nonwhite, and treated more recently and who had changed employment because of cancer were significantly more likely to report any material financial hardship. Cancer survivors who were uninsured, had lower family income, and were treated more recently were more likely to report psychological financial hardship. Among cancer survivors ≥ 65 years of age, those who were younger were more likely to report any financial hardship. Conclusion Cancer survivors, especially the working-age population, commonly experience material and psychological financial hardship.

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Food insecurity among adult cancer survivors in the United States

Journal of Cancer Survivorship ◽

10.1007/s11764-019-00783-9 ◽

2019 ◽

Vol 13 (4) ◽

pp. 641-652 ◽

Cited By ~ 1

Author(s):

M. L. Trego ◽

Z. M. Baba ◽

K. I. DiSantis ◽

M. L. Longacre

Keyword(s):

United States ◽

Food Insecurity ◽

Cancer Survivors ◽

The United States ◽

Adult Cancer Survivors

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Mental health outcomes in a national sample of adult cancer survivors in the United States: Has psychosocial care improved?

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.31_suppl.120 ◽

2013 ◽

Vol 31 (31_suppl) ◽

pp. 120-120

Author(s):

Robin L. Whitney ◽

Janice F. Bell ◽

Jill G. Joseph ◽

Richard J. Bold

Keyword(s):

Mental Health ◽

United States ◽

Psychological Distress ◽

Chronic Disease ◽

Cancer Survivors ◽

Cancer Care ◽

Unmet Need ◽

The United States ◽

Care Quality ◽

Adult Cancer Survivors

120 Background: Recent cancer care recommendations include routine mental health (MH) screening and support. We provide national estimates of psychological distress, MH visits, and unmet need (defined as having distress but no MH visit) for MH services among adult cancer survivors. Additionally, we test for temporal differences between years 2005 and 2010 to assess whether the estimates differ before and after important policy recommendations for psychosocial cancer care. Methods: This study analyzed cross-sectional data from the National Health Interview Survey (NHIS), years 2005 and 2010, for adults (≥18yrs) in the United States (n=58,585) categorized as having: 1) no chronic disease; 2) chronic disease other than cancer; 3) cancer without co-morbid chronic disease; 4) cancer with co-morbid chronic disease. In these four groups we compared psychological distress, MH visits, and unmet need for MH services. Survey-weighted logistic regression was used to model the dependent variables as functions of disease status, socio-demographic variables and self-reported health status. Estimates are generalizable to the US civilian non-institutionalized population. Results: Compared to the group with no chronic disease, the cancer with co-morbid chronic disease group had the highest odds of psychological distress (OR 2.78; 95% CI: 2.18, 3.54) and MH visits (OR 1.7; 95% CI: 1.42, 2.05), with no change from 2005 to 2010. The other two groups (cancer without co-morbid chronic disease and chronic disease other than cancer) also had statistically significantly higher odds of both outcomes compared to those with no chronic disease. Among individuals with cancer, estimates of unmet need for MH services were significantly lower in 2010 (OR 1.53; 95% CI: 1.03, 1.88) compared to 2005 (OR 2.89; 95% CI: 2.09, 3.99). Conclusions: Individuals with cancer have disproportionate MH needs. We find evidence of MH care quality improvement among individuals with cancer between 2005 and 2010, a time period that coincides with continued policy and clinical attention to psychosocial needs in this population. These efforts appear to have reduced, but not eliminated, unmet need for MH services for individuals with cancer.

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Challenges to Standardizing the Care for Adult Cancer Survivors: Highlighting ASCO's Fatigue and Anxiety and Depression Guidelines

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2015.35.188 ◽

2015 ◽

pp. 188-194 ◽

Cited By ~ 1

Author(s):

Ann H. Partridge ◽

Paul B. Jacobsen ◽

Barbara L. Andersen

Keyword(s):

United States ◽

Health Care ◽

Early Detection ◽

Cancer Survivors ◽

Health Care System ◽

The United States ◽

Anxiety And Depression ◽

Psychosocial Issues ◽

Adult Cancer Survivors ◽

Growing Population

There are over 14 million survivors of cancer living in the United States alone and tens of millions more worldwide, with this population expected to nearly double in the next decade. The successes of prevention, early detection, and better therapies have lead to an emerging understanding of the substantial medical and psychosocial issues for this growing population that must be tackled for individuals and from the health care system and societal perspectives.

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