Cancer survivors decline care, due to out of pocket expense

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In the United States, more than one million cancer survivors are foregoing medical care due to associated costs, according to data presented at the American Association for Cancer Research conference on the Science of Health Care Disparities. Additionally, Hispanics and African-Americans were found to be twice as likely to go without services. "These survivors are either going without, or significantly delaying, dental care, general medical care, mental healthcare or prescription drugs," said Kathryn Weaver, PhD, a cancer prevention fellow at the National Cancer Institute.

Although insurance status did play a role, foregoing care due to cost still persisted among the insured. "There are significant out-of-pocket expenses, even for those with insurance," said Weaver.

Weaver and colleagues used data from the Center for Disease Control's National Health Interview Survey, which is conducted annually and questions about 30,000 to 40,000 households, to identify 6,602 adult cancer survivors. Of these survivors, 64.3 percent were female, 4.8 percent were Hispanic, 6.4 percent were non-Hispanic black and 88.8 percent were non-Hispanic white.

What they discovered was that the prevalence of foregoing medical care due to cost was 7.8 percent for general medical care, 9.9 percent for prescription medication, 11.3 percent for dental care and 2.7 percent for mental healthcare.

Compared to non-Hispanic whites, Hispanics were 2.14-fold more likely to forego prescription medications due to cost concerns and African-Americans were 87 percent more likely to forego prescriptions.

These differences persisted after statistical adjustments for education, health insurance coverage and non-cancer medical comorbidities.

"Efforts to expand insurance coverage might go some way toward addressing these problems, but absent that, clinicians need to be more aware that their patients are not getting these services and work to try to connect them to charity or low-cost care," said Weaver.