Supportive Care in Cancer

, Volume 24, Issue 11, pp 4739–4746

The impact of cancer diagnosis and treatment on employment, income, treatment decisions and financial assistance and their relationship to socioeconomic and disease factors

  • Christine Paul
  • Allison Boyes
  • Alix Hall
  • Alessandra Bisquera
  • Annie Miller
  • Lorna O’Brien
Original Article

DOI: 10.1007/s00520-016-3323-y

Cite this article as:
Paul, C., Boyes, A., Hall, A. et al. Support Care Cancer (2016) 24: 4739. doi:10.1007/s00520-016-3323-y

Abstract

Purpose

The financial impact of cancer diagnosis and treatment can be considerable to individuals and their households, leading to changes in treatment decision making. This study aimed to quantify effects on income and employment; describe how cost-related factors influence treatment decision making and need for financial assistance; and to identify patient sociodemographic factors associated with treatment decision making, use of financial assistance and financial effects.

Methods

A cross-sectional self-report questionnaire was administered to oncology outpatients from two hospitals in Australia: one regional and one metropolitan.

Results

Of 255 participants, 67 % indicated a change in employment and 63 % of those reported reduced household income since their diagnosis. Travel (15 %), loss of income (14 %) and cost of treatments (11 %) were commonly cited factors influencing treatment decision making. Seventy-four percent of participants reported that they did not access financial assistance, with more than a third (37 %) of those being unaware that financial assistance was available. Being currently not employed and more recent diagnosis were associated with a reduced income since diagnosis. After adjusting for employment status and age, patients with private health insurance had higher odds of reporting that financial factors had influenced treatment decision making (OR = 2.5).

Conclusion

Unemployment is a major driver of the financial impact of cancer. The costs of treatment may be particularly challenging for those with private health insurance who are more likely to be treated in the private health system where out-of-pocket costs are greater. Improved access to financial assistance is required to better avoid potential inequities.

Keywords

Cancer Oncology Treatment Decision making Employment Cross-sectional studies 

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Christine Paul
    • 1
    • 2
  • Allison Boyes
    • 1
    • 2
  • Alix Hall
    • 1
    • 2
  • Alessandra Bisquera
    • 3
  • Annie Miller
    • 4
  • Lorna O’Brien
    • 4
  1. 1.School of Medicine and Public HealthUniversity of NewcastleCallaghanAustralia
  2. 2.Priority Research Centre for Health BehaviourHunter Medical Research InstituteNew Lambton HeightsAustralia
  3. 3.Clinical Research Design, Information Technology and Statistical SupportHunter Medical Research InstituteNew Lambton HeightsAustralia
  4. 4.Cancer Council NSWSydneyAustralia

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