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Cancer survivors’ experiences with insurance, finances, and employment: results from a multisite study

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Abstract

Background

Cancer has significant implications on survivors’ insurance coverage, financial status, and employment. We aimed to examine how these outcomes vary for survivors of different cancer types.

Methods

Using the Cancer Survivorship Supplement of the Medical Expenditures Panel Survey (MEPS), in 2013, we surveyed survivors of five common cancers who were diagnosed during 2003–2008 and were continuously enrolled in one of three health plans in Massachusetts, Colorado, and Washington State.

Results

Among 615 eligible respondents, 96 % reported having health insurance at the time of or since diagnosis; of those, few reported barriers in coverage to visit doctors or facilities of their choice. Approximately 15 % reported experiencing financial hardships due to cancer. Of the 334 who responded as having been employed at the time of or since diagnosis, approximately 25 % reported that they or their spouses remained at their jobs due to concerns about losing medical insurance. Further, 63 % reported making changes in their jobs or careers (e.g., took extended time off, worked part time, or declined promotion) due to cancer, and 42 % reported that cancer interfered with their physical and/or mental tasks at work or reduced productivity. Negative employment and financial implications were most common among those with lung, breast, and colorectal cancer, and those diagnosed before age 65.

Conclusions

In this insured population, few experienced restrictions in cancer care coverage, though maintaining health insurance often drove employment decisions. Significant negative effects on finances and employment were observed among specific cancer types and younger survivors.

Implications for Cancer Survivors

Our study findings emphasize a need to identify ways of supporting survivors and provide tailored resources to reduce the untoward financial and work-related implications of cancer.

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Author information

Author notes

  1. Borsika Rabin

    Present address: Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California, USA

  2. Stephanie Nutt

    Present address: Texas Department of State Health Services, Austin, TX, USA

Authors and Affiliations

  1. Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, 133 Brookline Avenue, 6th Floor, Boston, MA, 02215, USA

    Larissa Nekhlyudov

  2. Group Health Research Institute, Seattle, WA, USA

    Rod Walker, Rebecca Ziebell & Jessica Chubak

  3. Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA

    Borsika Rabin

  4. Department of Family Medicine and Adult and Child Center for Health Outcomes and Delivery Science, School of Medicine, University of Colorado, Aurora, CO, USA

    Borsika Rabin

  5. LIVESTRONG Foundation, Austin, TX, USA

    Stephanie Nutt

Authors
  1. Larissa Nekhlyudov
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  2. Rod Walker
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  4. Borsika Rabin
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  6. Jessica Chubak
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Corresponding author

Correspondence to Larissa Nekhlyudov.

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Funding

The study was funded by the LIVESTRONG Foundation. The collection of Group Health cancer incidence data was supported by the Cancer Surveillance System of the Fred Hutchinson Cancer Research Center, which is funded by Contract No. N01-CN-67009 and N01-PC-35142 from the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute with additional support from the Fred Hutchinson Cancer Research Center and the State of Washington. The HMORN virtual data warehouse is supported in part through the Cancer Research Network (award number U24CA171524 from the National Cancer Institute).

Conflict of interest

Rod Walker has received funding as a biostatistician from an unrelated research grant awarded to Group Health Research Institute from Pfizer.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards and approved by the institutional research boards at all involved sites.

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Nekhlyudov, L., Walker, R., Ziebell, R. et al. Cancer survivors’ experiences with insurance, finances, and employment: results from a multisite study. J Cancer Surviv 10, 1104–1111 (2016). https://doi.org/10.1007/s11764-016-0554-3

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  • DOI: https://doi.org/10.1007/s11764-016-0554-3

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