Cancer’s impact extends far beyond the physical realm. Recent research reveals the substantial and enduring financial burden faced by cancer patients in the US, often leading to diminished credit scores and even bankruptcy. While the US boasts impressive cancer-related outcomes, including lower mortality rates compared to other high-income countries, the cost of cancer treatment and healthcare overall is significantly higher. This financial strain is a well-documented issue, but new studies presented at the American College of Surgeons (ACS) Clinical Congress 2024 provide compelling empirical evidence of the financial fallout experienced by cancer patients.
Quantifying the Financial Impact of Cancer
The first study analyzed credit bureau data from Experian, focusing on patients listed in the Massachusetts Cancer Registry diagnosed between 2010 and 2019. Comparing these patients to a control group without cancer, the researchers found significantly higher rates of debt collection, particularly medical-related debt, among cancer patients. Alarmingly, cancer patients were nearly five times more likely to declare bankruptcy, and their average credit score was approximately 80 points lower than their non-cancer counterparts.
Risk Factors and Long-Term Consequences
The second study delved into a subset of colorectal cancer patients, exploring risk factors associated with financial hardship. Patients receiving only radiation therapy had credit scores 62 points lower than those undergoing surgery, suggesting that different treatment modalities carry varying financial implications. Patients receiving both surgery and chemoradiation appeared to fare better, with credit scores slightly higher than those receiving surgery alone. Furthermore, patients with bladder, liver, lung, and colorectal cancers experienced more pronounced declines in their credit scores, with the negative impact lasting up to 9.5 years. Other risk factors for increased financial toxicity included being under 62, not owning a home, being unmarried, earning less than $52,000 annually, and being Black or Hispanic.
Methodological Challenges and Breakthroughs
This research involved navigating significant hurdles, as credit bureaus are restricted from sharing identifiable data. The Massachusetts Cancer Registry (MCR) securely provided patient data to Experian, which then matched it with their credit data. Experian then anonymized the combined data before providing it to the researchers, a process that took five years. This meticulous approach enabled an objective comparison of the financial trajectories of cancer patients and non-patients, a feat not achieved by previous studies relying on subjective survey data.
Implications for Policy and Future Research
Lead researcher Benjamin James, chief of general surgery at Beth Israel Deaconess Medical Center and associate professor of surgery at Harvard Medical School, emphasized the significance of these findings as the first to offer numerical evidence of financial toxicity among cancer survivors. Given that the data originates from Massachusetts, a state with mandated universal health coverage, the financial strain on cancer patients in other states could be even greater.
Recent changes in credit reporting, such as the removal of paid and small amounts of unpaid medical debt, and proposed rules to ban medical bills from credit reports entirely, offer a glimmer of hope. However, the researchers advocate for more comprehensive measures to protect patients from the crippling costs of cancer treatment.
A Call for Action
The persistence of financial challenges, even in a state with relatively high insurance coverage, underscores the need for broader policy changes and reforms, including a reevaluation of debt collection practices. Further research is crucial, but financial security should be a priority in cancer care, ensuring that patients can focus on their health without the added burden of overwhelming financial strain.
American College of Surgeons (ACS) Clinical Congress 2024
Cancer Treatment Costs
Health Care Costs
Financial Troubles for Cancer Patients
Impact of Medical Debt Removal on Credit Scores
Proposed Rule on Medical Bills and Credit Reports
