The financial impact of cancer on Canadian young adults

Abstract

Purpose

To explore the financial impact of cancer in young adults (YAs) compared to matched non-cancer peers.

Methods

Five hundred seventy-five YAs from the Young Adults with Cancer in their Prime (YACPRIME) study reported on out-of-pocket cancer costs and missed work. YA cancer survivors were compared to matched peers without cancer on key financial indices based on current age (< 35 vs. 35 + years) and time since diagnosis (< 5 vs. 5 + years). Descriptive statistics, Chi-square tests, and prevalence ratios (PR) were used to compare groups on financial variables.

Results

Almost 60% of YA survivors spent at least $100/month on cancer-related expenses, and 49% missed at least one year of work. YA survivors were more likely to have outstanding credit card ((< 35 (PR = 1.37, p = 0.001); 35 + (PR = 1.33, p = 0.001)) and line of credit (< 35 (PR = 1.42, p = 0.008); 35 + (PR = 1.27, p = 0.016)) balances. Home ownership was higher among non-cancer peers ((< 35: PR = 1.42, p < 0.001); 35 + (PR = 1.69, p < 0.001); < 5 years (PR = 1.39, p < 0.001); 5 + years (PR = 1.41, p = 0.005)). YA survivors were more likely to not own assets ((< 5 years (PR = 2.25, p < 0.001); 5 + years (PR = 2.25, p = 0.004)). Those diagnosed within 5 years had higher rates of payday loans (PR = 3.91, p = 0.021).

Conclusion

While exploratory, results suggest that YAs are disadvantaged compared to their peers in type and value of assets owned and debts carried.

Implications for Cancer Survivors

Survivorship care plans for YA survivors should include resources to manage the financial impacts of cancer.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by a patient-oriented grant from the Newfoundland and Labrador Support for People and Person Oriented Research and Trials unit and the Collaborative Applied Research in Economics initiative. Dr. Garland is funded by a Beatrice Hunter Cancer Research Institute and Scotiabank New Investigator Award.

Author information

Affiliations

Authors

Contributions

Sheila Garland, Geoff Eaton and Karine Chalifour contributed to the study conception and design. Material preparation, data collection and analysis were performed by Kaitlyn Mahon, Breanna Lane, Sheila Garland, Ken Fowler, Geoff Eaton and Karine Chalifour. The first draft of the manuscript was written by Kaitlyn Mahon and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sheila N. Garland.

Ethics declarations

Ethics approval

This study was approved by Memorial University’s Interdisciplinary Committee on Ethics in Human Research (reference number 20170502).

Consent to participate

All study participants gave informed consent before completing the YACPRIME survey.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Financial questions

Financial questions

  1. 1.

    How much money do you estimate you spend out of pocket per month on cancer-related expenses (e.g., hospital parking, medications not covered by insurance, costs for other treatment providers (physiotherapists, psychologists, acupuncturists, etc.), travel, and accommodations)?*

    • Less than $100

    • $100–$250

    • $250–$500

    • $500–$1000

    • $1000 or more

  2. 2.

    Which of the following categories best describes your personal income in 2016?**

    • None or < $20,000

    • $20,000 to less than $40,000

    • $40,000 to less than $60,000

    • $60,000 to less than $80,000

    • $80,000 or more

  3. 3.

    Which of the following categories best describes your total household income in 2016?**

    • None or < $20,000

    • $20,000 to less than $40,000

    • $40,000 to less than $60,000

    • $60,000 to less than $80,000

    • $80,000 or more

  4. 4.

    Do you or does anyone in your family currently have any of the following types of debts and liabilities? (this includes yourself and your immediate family, e.g., spouse or partner but not parents)***

    • Mortgages

    • Student loans

    • Payday loans

    • Other loans

    • Outstanding credit card balance

    • Outstanding line of credit balance

    • None

    • Other

  5. 5.

    In your estimation, what is the total value of these debts and liabilities?***

    • Less than $50,000

    • $50,000 to $99,999

    • $100,000 to $149,999

    • $150,000 to $199,999

    • $200,000 to $249,999

    • $250,000 or more

  6. 6.

    Do you or does anyone in your family own any of the following tangible assets? (This includes yourself and your immediate family, e.g. spouse or partner but not parents)***

    • House or property

    • Vehicles

    • Collections, antiques, jewels and other valuables

    • None

    • Other

  7. 7.

    How much do you think these assets could be sold for today?***

    • Less than $100,000

    • $100,000 to less than $200,000

    • $200,000 to less than $300,000

    • $300,000 to less than $500,000

    • $500,000 or more

  8. 8.

    How much work have you missed because of your cancer diagnosis and/or treatment?*

    • Less than 30 days

    • 30 days to less than 6 months

    • 6 months to less than 1 year

    • 1 year to less than 3 years

    • 3 years or more

  9. 9.

    Do you have insurance that covers all or part of your prescription medications?*

    • Yes

    • No

  10. 10.

    Is your insurance a government sponsored plan, an employer sponsored benefit plan, or a plan sponsored through an association such as a union, trade association, or student organization?*

    • A government-sponsored plan

    • An employer-sponsored benefit plan

    • A plan sponsored through an association such as a union, trade association or student organization

    • Other

Note: *Questions were only asked for the YACPRIME sample, Canadian Dollars 

**Questions were taken from the CCHS

***Questions were taken from the CFCS

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Mahon, K.N., Garland, S.N., Eaton, G. et al. The financial impact of cancer on Canadian young adults. J Cancer Surviv (2021). https://doi.org/10.1007/s11764-021-00998-9

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Keywords

  • Cancer
  • Costs
  • Financial toxicity
  • Health expenditures
  • Young adults