A new analysis has found that two million cancer survivors did not get needed medical services in the previous year because of concerns about cost. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the study raises the concern that the long-term health and well-being of cancer survivors could suffer because patients have financial worries about their care.

Kathryn Weaver, PhD, MPH, of Wake Forest University Baptist Medical Center in Winston-Salem led a team that examined the prevalence of forgoing care due to financial concerns. They sought todetermine whether cancer history and race or ethnicity were associated with individuals’ likelihood to go without care. The investigators analyzed information from the annual US National Health Interview Survey (NHIS), an in person, nationwide survey of approximately 30,000 to 40,000 households in the civilian, non-institutionalized population that is used to track trends in illness and disability in the United States. Data from 6,602 adult cancer survivors and 104,364 individuals with no history of cancer who were surveyed in the 2003 to 2006 NHIS were included in the study.

Disparities among cancer survivors were largely reflective of those in the general adult population. Among cancer survivors, the  prevalence of forgoing care in the past year due to cost was 7.8 percent for medical care, 9.9 percent for prescription medications, 11.3 percent for dental care, and 2.7 percent for mental health care. Cancer survivors under the age of 65 years were 55 percent more likely to delay or forgo all types of medical care than their same age peers without a history of cancer. “This is important because cancer survivors have many medical needs that persist for years after their diagnosis and treatment,” said Dr. Weaver. Hispanic and black cancer survivors were more likely to go without prescription medications and dental care than white survivors.

This analysis revealed that 18 percent of US cancer survivors, which would mean an estimated more than two million individuals, did not get one or more needed medical services because of financial concerns. “Future research needs to examine the impact of forgoing care on survivors’ quality of life and survival,” the authors concluded. Dr. Weaver noted that it will also be interesting to observe how recent health care reform efforts might impact access to care for cancer survivors.

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