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The financial impact of cancer on Canadian young adults

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


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.


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).


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.


  1. Statistics, C.C.S.s.A.C.o.C. Canadian Cancer Statistics 2017. 2017; Available from: from: Statistics-2017-EN.pdf.

  2. Cancer, C.P.A., Adolescents & young adults with cancer: a system performance report. 2017: Toronto, Ontario.

  3. Kim B, Patterson P, White K. Developmental considerations of young people with cancer transitioning to adulthood. Hoboken: Wiley; 2018.

    Book  Google Scholar 

  4. Hartnett CS, Furstenberg FF, Birditt KS, Fingerman KL. Parental support during young adulthood: why does assistance decline with age? J Fam Issues. 2013;34(7):975–1007.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Clark W. Delayed transitions of young adults. Canad Social Trends. 2007;84:14–22.

    Google Scholar 

  6. Webley P, ProQuest. The economic psychology of everyday life. Philadelphia: Psychology Press; 2001.

    Google Scholar 

  7. Guy GP, et al. Estimating the health and economic burden of cancer among those diagnosed as adolescents and young adults. Health aff (Project Hope). 2014;33(6):1024–31.

    Article  Google Scholar 

  8. Parsons HM, Harlan LC, Lynch CF, Hamilton AS, Wu XC, Kato I, et al. Impact of cancer on work and education among adolescent and young adult cancer survivors. J Clin Oncol. 2012;30(19):2393–400.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Palacios M, Barua B, d. Canadian Electronic Library. The price of public health care insurance, 2018. Vancouver: Fraser Institute; 2018.

    Google Scholar 

  10. Papanicolas I, Woskie L, Jha A. Health Care Spending in the United States and Other High-Income Countries. Jama-J Am Med Assoc. 2018;319(10):1024–39.

    Article  Google Scholar 

  11. Soril LJJ, et al. Is Canadian healthcare affordable? a comparative analysis of the Canadian healthcare system from 2004 to 2014. Healthcare policy = Politiques de sante. 2017;13(1):43–58.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Teckle P, et al. Long- term effects of cancer on earnings of childhood, adolescent and young adult cancer survivors – a population- based study from British Columbia, Canada. BMC Health Serv Res. 2018;18(1):826.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Wiczer D. Earnings losses through unemployment and unemployment duration. Econ Synop. 2017;2017:13.

    Google Scholar 

  14. Canada, S. Canadian income survey. 2016; Available from:

    Google Scholar 

  15. Canadian community health survey, S. Canada, Editor. 2014.

  16. Canadian financial capability survey, S. Canada, Editor. 2014.

  17. Understanding statistics used to guide prognosis and evaluate treatment. Available from:

  18. Thompson ML, Myers JE, Kriebel D. Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? Occup Environ Med. 1998;55(4):272–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Norton EC, Dowd BE, Maciejewski ML. Odds ratios—current best practice and use. J Am Med Assoc. 2018;320(1):84–5.

    Article  Google Scholar 

  20. Bleyer WA, Barr RD, SpringerLink. Cancer in adolescents and young adults. Berlin: Springer Berlin Heidelberg; 2007.

    Book  Google Scholar 

  21. Lemieux, T., The causal effect of education on earnings in Canada. Department of Economics, University of British Columbia, 2001.

  22. Statistics Canada. Does education pay? A comparison of earnings by level of education in Canada and its provinces and territories. 2017 [cited 2020 September 17, 2020]; Available from:×2016024-eng.pdf.

  23. Landwehr MS, Watson SE, Macpherson CF, Novak KA, Johnson RH. The cost of cancer: a retrospective analysis of the financial impact of cancer on young adults. Cancer Med. 2016;5(5):863–70.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Frenette M. Is post-secondary access more equitable in Canada or the United States? In: B. Statistics Canada. Analytical Studies, L. Canadian Electronic, and D. Statistics Canada, editor. Business and Labour Market Analysis. 2005. Ottawa: Statistics Canada, Analytical Studies.

  25. Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol. 2011;77(2):109–30.

    Article  PubMed  Google Scholar 

  26. Quintini, G. and S. Martin, Starting well or losing their way?: The position of youth in the labour market in OECD Countries. IDEAS Working Paper Series from RePEc, 2006.

  27. Lawrence EC, Elliehausen G. A comparative analysis of payday loan customers. Contemp Econ Policy. 2008;26(2):299–316.

    Article  Google Scholar 

  28. Canadian Electronic Library. Payday loans : market trends. Ottawa: Financial Consumer Agency of Canada; 2016.

    Google Scholar 

  29. Canada, F.C.A.o. Payday loans. 2019; Available from:

  30. Statistics Canada (2020). Consumer price index, monthly, not seasonally adjusted. Available from:

  31. Léonard, A., The employment insurance program in Canada : how it works, ed. P. Canada. Library of and S. Canada. Parliamentary Information and Research. 2010, Ottawa: Ottawa : Library of Parliament.

  32. Canada, G.o. The Canada pension plan disability benefits. Available from:

  33. Society, A.C., Special section: cancer in adolescents and young adults. 2020.

    Google Scholar 

  34. Altice CK, et al. Financial hardships experienced by cancer survivors: a systematic review. J Natl Cancer Inst. 2017;109(2):1–17.

    Article  Google Scholar 

  35. Hopkins RB, Goeree R, Longo CJ. Estimating the national wage loss from cancer in Canada. Curr Oncol. 2010;17(2):40–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Fenn KM, Evans SB, McCorkle R, DiGiovanna MP, Pusztai L, Sanft T, et al. Impact of financial burden of cancer on survivors' quality of life. J oncol Pract. 2014;10(5):332–8.

    Article  PubMed  Google Scholar 

  37. Lu L, O'Sullivan E, Sharp L. Cancer-related financial hardship among head and neck cancer survivors: Risk factors and associations with health-related quality of life. Psycho-oncology. 2019;28(4):863–71.

    Article  PubMed  Google Scholar 

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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

Authors and Affiliations



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.

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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 17, 174–186 (2023).

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