Skip to main content
SpringerLink
Log in

Exploring barriers to the receipt of necessary medical care among cancer survivors under age 65 years

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

With increasing cancer care costs and greater patient cost-sharing in the USA, understanding access to medical care among cancer survivors is imperative. This study aims to identify financial, psychosocial, and cancer-related barriers to the receipt of medical care, tests, or treatments deemed necessary by the doctor or patient for cancer among cancer survivors age < 65 years.

Methods

We used data on 4321 cancer survivors aged 18–64 years who completed the 2012 LIVESTRONG Survey. Multivariable logistic regression was used to identify risk factors associated with the receipt of necessary medical care, including sociodemographic, financial hardship, debt amount, caregiver status, and cancer-related variables.

Results

Approximately 28% of cancer survivors were within 1 year, and 43% between 1 and 5 years, since their last treatment at the time of survey. Nearly 9% of cancer survivors reported not receiving necessary medical care. Compared to survivors without financial hardship, the likelihood of not receiving necessary medical care significantly increased as the amount of debt increased among those with financial hardship (RRFinancial hardship w/< $10,000 debt = 1.94, 95% CI 1.55–2.42, and RR RRFinancial hardship w/≥ $10,000 debt = 3.41, 95% CI 2.69–4.33, p < 0.001). Survivors who reported lack of a caregiver, being uninsured, and not receiving help understanding medical bills were significantly more likely to not receive necessary medical care.

Conclusion

We identified key financial and insurance risk factors that may serve as significant barriers to the receipt of necessary medical care among cancer survivors age < 65 in the USA

Implications for cancer survivors

The majority of cancer survivors reported receiving medical care either they or their doctors deemed necessary. However, identifying potentially modifiable barriers to receipt of necessary medical cancer care among cancer survivors age < 65 is imperative for developing interventions to ensure equitable access to care and reducing cancer disparities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271–89.

    Article  PubMed  Google Scholar 

  2. Howlader N, Noone AM, Krapacho M, Garshell J, Miller D, Altekruse SF, et al. SEER Cancer Statistics Review, 1975–2012 Bethesda, MD: National Cancer Institute; 2015 [Available from: http://seer.cancer.gov/csr/1975_2012/, based on November 2014 SEER data submission, posted to SEER website, April 2015.

  3. Institute of Medicine (IOM). Ensuring patient access to affordable cancer drugs: workshop summary. Washington, DC: The National Academies Press; 2014.

    Google Scholar 

  4. Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML. Projections of the cost of cancer care in the United States: 2010–2020. J Natl Cancer Inst. 2011;103(2):117–28.

    Article  PubMed  PubMed Central  Google Scholar 

  5. American Society of Clinical Oncology. The state of cancer Care in America, 2016: a report by the American Society of Clinical Oncology. J Oncol Pract. 2016;12(4):339–83.

    Article  PubMed Central  Google Scholar 

  6. Office CB. Congressional Budget Office: Insurance Coverage Provisions of the Affordable Care Act: CBO’s March 2015 Baseline Washington, D.C.: Congressional Budget Office; 2015 [Available from: https://www.cbo.gov/sites/default/files/51298-2015-03-ACA.pdf.

  7. Collins SR, Rasmussen PW, Beutel S, Doty MM. The problem of underinsurance and how rising deductibles will make it worse. Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014. Issue Brief (Commonw Fund). 2015;13:1–20.

    Google Scholar 

  8. Kaiser Family Foundation. Health Research & Education Trust. Employer health benefits. In: Annual survey. Merlo Park: Henry J. Kaiser Family Foundation; 2015.

    Google Scholar 

  9. Tefferi A, Kantarjian H, Rajkumar SV, Baker LH, Abkowitz JL, Adamson JW, et al. In support of a patient-driven initiative and petition to lower the high price of cancer drugs. Mayo Clin Proc. 2015;90(8):996–1000.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Yabroff KR, Dowling EC, Guy GP Jr, Banegas MP, Davidoff A, Han X, et al. Financial hardship associated with cancer in the United States: findings from a population-based sample of adult cancer survivors. J Clin Oncol. 2016;34(3):259–67.

    Article  PubMed  Google Scholar 

  11. Banegas MP, Guy GP Jr, de Moor JS, Ekwueme DU, Virgo KS, Kent EE, et al. For working-age cancer survivors, medical debt and bankruptcy create financial hardships. Health Aff (Millwood). 2016;35(1):54–61.

    Article  Google Scholar 

  12. Dusetzina SB, Winn AN, Abel GA, Huskamp HA, Keating NL. Cost sharing and adherence to tyrosine kinase inhibitors for patients with chronic myeloid leukemia. J Clin Oncol. 2014;32(4):306–11.

    Article  PubMed  Google Scholar 

  13. Goldman DP, Jena AB, Lakdawalla DN, Malin JL, Malkin JD, Sun E. The value of specialty oncology drugs. Health Serv Res. 2010;45(1):115–32.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kaisaeng N, Harpe SE, Carroll NV. Out-of-pocket costs and oral cancer medication discontinuation in the elderly. J Manag Care Spec Pharm. 2014;20(7):669–75.

    PubMed  Google Scholar 

  15. Streeter SB, Schwartzberg L, Husain N, Johnsrud M. Patient and plan characteristics affecting abandonment of oral oncolytic prescriptions. J Oncol Pract. 2011;7(3 Suppl):46s–51s.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Zafar SY, Peppercorn JM, Schrag D, Taylor DH, Goetzinger AM, Zhong X, et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient’s experience. Oncologist. 2013;18(4):381–90.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Nipp RD, Zullig LL, Samsa G, Peppercorn JM, Schrag D, Taylor DH, Jr., et al. Identifying cancer patients who alter care or lifestyle due to treatment-related financial distress. Psychooncology. 2015;25(6):719–25.

  18. Kent EE, Forsythe LP, Yabroff KR, Weaver KE, de Moor JS, Rodriguez JL, et al. Are survivors who report cancer-related financial problems more likely to forgo or delay medical care? Cancer. 2013;119(20):3710–7.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Weaver KE, Rowland JH, Bellizzi KM, Aziz NM. Forgoing medical care because of cost: assessing disparities in healthcare access among cancer survivors living in the United States. Cancer. 2010;116(14):3493–504.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Zheng Z, Han X, Guy GP Jr, Davidoff AJ, Li C, Banegas MP, et al. Do cancer survivors change their prescription drug use for financial reasons? Findings from a nationally representative sample in the United States. Cancer. 2017;123(8):1453–63.

    Article  PubMed  Google Scholar 

  21. Keegan TH, Tao L, DeRouen MC, Wu XC, Prasad P, Lynch CF, et al. Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers? J Cancer Surviv. 2014;8(2):282–92.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Potosky AL, Harlan LC, Albritton K, Cress RD, Friedman DL, Hamilton AS, et al. Use of appropriate initial treatment among adolescents and young adults with cancer. J Natl Cancer Inst. 2014;106(11). https://doi.org/10.1093/jnci/dju300.

  23. Society AC. Cancer treatment & survivorship facts & figures 2016–2017. American Cancer Society: Atlanta; 2016.

    Google Scholar 

  24. Foundation L. Survivors’ experiences with employment. LIVESTRONG Foundation: Austin; 2013.

    Google Scholar 

  25. Foundation L. Survivors’ experience with finances and insurance. Austin: LIVESTRONG Foundation; 2014.

    Google Scholar 

  26. Zheng Z, Yabroff KR, Guy GP, Jr., Han X, Li C, Banegas MP, et al. Annual medical expenditure and productivity loss among colorectal, female breast, and prostate cancer survivors in the United States. J Natl Cancer Inst. 2016;108(5). https://doi.org/10.1093/jnci/djv382.

  27. LIVESTRONG Foundation. LIVESTRONG Surveys. 2016. [Available from: https://www.livestrong.org/what-we-do/livestrong-surveys.

  28. Yabroff KR, Dowling E, Rodriguez J, Ekwueme DU, Meissner H, Soni A, et al. The Medical Expenditure Panel Survey (MEPS) experiences with cancer survivorship supplement. J Cancer Surviv. 2012;6(4):407–19.

    Article  PubMed  Google Scholar 

  29. Agency for Healthcare Research and Quality. Summary of Recommendations from Round 1 Cognitive Testing of the MEPS Cancer SAQ. AHRQ, Rockville. [Available from: http://meps.ahrq.gov/mepsweb/survey_comp/hc_survey/2011/MEPS_Cancer_SAQ_R1_Results.htm.

  30. Zullig LL, Peppercorn JM, Schrag D, Taylor DH, Lu Y, Samsa G. Financial distress, use of cost-coping strategies, and adherence to prescription medication among patients with cancer. J Oncol Pract. 2013;9(6 SUPPL):60s–3s.

    Article  PubMed Central  Google Scholar 

  31. Veenstra CM, Regenbogen SE, Hawley ST, Griggs JJ, Banerjee M, Kato I, et al. A composite measure of personal financial burden among patients with stage III colorectal cancer. Med Care. 2014;52(11):957–62.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36(1):1–10.

    Article  CAS  PubMed  Google Scholar 

  33. Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373–9.

    Article  CAS  PubMed  Google Scholar 

  34. Kiernan M, Kraemer HC, Winkleby MA, King AC, Taylor CB. Do logistic regression and signal detection identify different subgroups at risk? Implications for the design of tailored interventions. Psychol Methods. 2001;6(1):35–48.

    Article  CAS  PubMed  Google Scholar 

  35. Andreescu C, Mulsant BH, Houck PR, Whyte EM, Mazumdar S, Dombrovski AY, et al. Empirically derived decision trees for the treatment of late-life depression. Am J Psychiatry. 2008;165(7):855–62.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Thanassi W, Noda A, Hernandez B, Newell J, Terpeluk P, Marder D, et al. Delineating a retesting zone using receiver operating characteristic analysis on serial QuantiFERON tuberculosis test results in US healthcare workers. Pulm Med. 2012;2012:291294.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Vuong QH. Likelihood ratio tests for model selection and non-nested hypotheses. Econometrica. 1989;57(2):307–33.

    Article  Google Scholar 

  38. Kleinman LC, Norton EC. What’s the risk? A simple approach for estimating adjusted risk measures from nonlinear models including logistic regression. Health Serv Res. 2009;44(1):288–302.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Jagsi R, Pottow JA, Griffith KA, Bradley C, Hamilton AS, Graff J, et al. Long-term financial burden of breast cancer: experiences of a diverse cohort of survivors identified through population-based registries. J Clin Oncol. 2014;32(12):1269–76.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Shankaran V, Jolly S, Blough D, Ramsey SD. Risk factors for financial hardship in patients receiving adjuvant chemotherapy for colon cancer: a population-based exploratory analysis. J Clin Oncol. 2012;30(14):1608–14.

    Article  PubMed  Google Scholar 

  41. Guy GP Jr, Yabroff KR, Ekwueme DU, Virgo KS, Han X, Banegas MP, et al. Healthcare expenditure burden among non-elderly cancer survivors, 2008-2012. Am J Prev Med. 2015;49(6 Suppl 5):S489–97.

    Article  PubMed  Google Scholar 

  42. Young RA, DeVoe JE. Who will have health insurance in the future? An updated projection. Ann Fam Med. 2012;10(2):156–62.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Shankaran V, Ramsey S. Addressing the financial burden of cancer treatment: from copay to Can't pay. JAMA Oncol. 2015;1(3):273–4.

    Article  PubMed  Google Scholar 

  44. Tamblyn R, Laprise R, Hanley JA, Abrahamowicz M, Scott S, Mayo N, et al. Adverse events associated with prescription drug cost-sharing among poor and elderly persons. J Am Med Assoc. 2001;285(4):421–9.

    Article  CAS  Google Scholar 

  45. Hsu J, Price M, Huang J, Brand R, Fung V, Hui R, et al. Unintended consequences of caps on Medicare drug benefits. N Engl J Med. 2006;354(22):2349–59.

    Article  CAS  PubMed  Google Scholar 

  46. Chandra A, Gruber J, McKnight R. Patient cost-sharing and hospitalization offsets in the elderly. Am Econ Rev. 2010;100(1):193–213.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Swartz K. Cost-sharing: Effects on spending and outcomes. The Robert Wood Johnson Foundation; 2010. http://www.rwjf.org/en/library/research/2011/12/cost-sharing--effects-onspending-and-outcomes.html.

  48. Hargraves JL, Hadley J. The contribution of insurance coverage and community resources to reducing racial/ethnic disparities in access to care. Health Serv Res. 2003;38(3):809–29.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Shi L, Stevens GD. Vulnerability and unmet health care needs. The influence of multiple risk factors. J Gen Intern Med. 2005;20(2):148–54.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Donelan K, DesRoches CM, Schoen C. Inadequate health insurance: costs and consequences. Med Gen Med. 2000;2(3):E37.

    CAS  Google Scholar 

  51. Siminoff LA, Ross L. Access and equity to cancer care in the USA: a review and assessment. Postgrad Med J. 2005;81(961):674–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Mayberry RM, Mili F, Ofili E. Racial and ethnic differences in access to medical care. Med Care Res Rev. 2000;57(Suppl 1):108–45.

    Article  PubMed  Google Scholar 

  53. Office of the Assistant Secretary for Planning and Evaluation. Health insurance coverage and the affordable care act. Washington, D.C.: Office of the Assistant Secretary for Planning and Evaluation; 2015.

    Google Scholar 

  54. Sommers A, Cunningham PJ. Medical bill problems steady for U.S. families, 2007–2010. Track Rep. 2011;(28):1–5.

  55. Hewitt ME, Bamundo A, Day R, Harvey C. Perspectives on post-treatment cancer care: qualitative research with survivors, nurses, and physicians. J Clin Oncol. 2007;25(16):2270–3.

    Article  PubMed  Google Scholar 

  56. Armes J, Crowe M, Colbourne L, Morgan H, Murrells T, Oakley C, et al. Patients’ supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol. 2009;27(36):6172–9.

    Article  PubMed  Google Scholar 

  57. McInnes DK, Cleary PD, Stein KD, Ding L, Mehta CC, Ayanian JZ. Perceptions of cancer-related information among cancer survivors: a report from the American Cancer Society’s studies of cancer survivors. Cancer. 2008;113(6):1471–9.

    Article  PubMed  Google Scholar 

  58. Beckjord EB, Arora NK, McLaughlin W, Oakley-Girvan I, Hamilton AS, Hesse BW. Health-related information needs in a large and diverse sample of adult cancer survivors: implications for cancer care. J Cancer Surviv. 2008;2(3):179–89.

    Article  PubMed  Google Scholar 

  59. Stein KD, Syrjala KL, Andrykowski MA. Physical and psychological long-term and late effects of cancer. Cancer. 2008;112(11 Suppl):2577–92.

    Article  PubMed  Google Scholar 

  60. Hanratty B, Holland P, Jacoby A, Whitehead M. Financial stress and strain associated with terminal cancer—a review of the evidence. Palliat Med. 2007;21(7):595–607.

    Article  PubMed  Google Scholar 

  61. Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ. What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer. 2009;17(8):1117–28.

    Article  PubMed  Google Scholar 

  62. Kim Y, Carver CS. Recognizing the value and needs of the caregiver in oncology. Curr Opin Support Palliat Care. 2012;6(2):280–8.

    Article  PubMed  Google Scholar 

  63. Glajchen M. The emerging role and needs of family caregivers in cancer care. J Support Oncol. 2004;2(2):145–55.

    PubMed  Google Scholar 

  64. Zafar SY. Financial toxicity of cancer care: It’s time to intervene. J Natl Cancer Inst. 2015;109(5):djv370.

    Google Scholar 

  65. Advani PS, Reitzel LR, Nguyen NT, Fisher FD, Savoy EJ, Cuevas AG, et al. Financial strain and cancer risk behaviors among African Americans. Cancer Epidemiol Biomark Prev. 2014;23(6):967–75.

    Article  Google Scholar 

  66. Bestvina CM, Zullig LL, Rushing C, Chino F, Samsa GP, Altomare I, et al. Patient-oncologist cost communication, financial distress, and medication adherence. J Oncol Pract. 2014;10(3):162–7.

    Article  PubMed  Google Scholar 

  67. Bona K, Dussel V, Orellana L, Kang T, Geyer R, Feudtner C, et al. Economic impact of advanced pediatric cancer on families. J Pain Symptom Manag. 2014;47(3):594–603.

    Article  Google Scholar 

  68. Bradshaw M, Ellison CG. Financial hardship and psychological distress: exploring the buffering effects of religion. Soc Sci Med. 2010;71(1):196–204.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Davidoff AJ, Erten M, Shaffer T. Out-of-pocket health care expenditure burden for Medicare beneficiaries with cancer. Cancer. 2013;119(6):1257–65.

    Article  PubMed  Google Scholar 

  70. de Boer A, Moffatt S, Noble E, White M. Addressing the financial consequences of cancer: qualitative evaluation of a welfare rights advice service. PLoS One. 2012;7(8):e42979.

    Article  Google Scholar 

  71. de Souza JA, Yap BJ, Hlubocky FJ, Wroblewski K, Ratain MJ, Cella D, et al. The development of a financial toxicity patient-reported outcome in cancer: the COST measure. Cancer. 2014;120(20):3245–53.

    Article  PubMed  Google Scholar 

  72. Ekwueme DU, Yabroff KR, Guy GP Jr, Banegas MP, de Moor JS, Li C, et al. Medical costs and productivity losses of cancer survivors—United States, 2008-2011. MMWR Morb Mortal Wkly Rep. 2014;63(23):505–10.

    PubMed  Google Scholar 

  73. Guy GP Jr, Ekwueme DU, Yabroff KR, Dowling EC, Li C, Rodriguez JL, et al. Economic burden of cancer survivorship among adults in the United States. J Clin Oncol. 2013;31(30):3749–57.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Guy GP Jr, Yabroff KR, Ekwueme DU, Smith AW, Dowling EC, Rechis R, et al. Estimating the health and economic burden of cancer among those diagnosed as adolescents and young adults. Health Aff (Millwood). 2014;33(6):1024–31.

    Article  Google Scholar 

  75. Howard DH, Molinari NA, Thorpe KE. National estimates of medical costs incurred by nonelderly cancer patients. Cancer. 2004;100(5):883–91.

    Article  PubMed  Google Scholar 

  76. Nekhlyudov L, Walker R, Ziebell R, Rabin B, Nutt S, Chubak J. Cancer survivors’ experiences with insurance, employment and personal finances: results from a multi-site study. J Clin Oncol. 2015;33(Suppl):Abstract 9574.

    Google Scholar 

  77. Pisu M, Kenzik KM, Oster RA, Drentea P, Ashing KT, Fouad M, et al. Economic hardship of minority and non-minority cancer survivors 1 year after diagnosis: another long-term effect of cancer? Cancer. 2015;121(8):1257–64.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Ramsey S, Blough D, Kirchhoff A, Kreizenbeck K, Fedorenko C, Snell K, et al. Washington state cancer patients found to be at greater risk for bankruptcy than people without a cancer diagnosis. Health Aff (Millwood). 2013;32(6):1143–52.

    Article  Google Scholar 

  79. Zafar SY, McNeil RB, Thomas CM, Lathan CS, Ayanian JZ, Provenzale D. Population-based assessment of cancer survivors’ financial burden and quality of life: a prospective cohort study. J Oncol Pract. 2015;11(2):145–50.

    Article  PubMed  Google Scholar 

  80. PDQ® Adult Treatment Editorial Board. PDQ Financial Toxicity and Cancer Treatment. National Cancer Institute, Bethesda; updated 05/03/17. Available from: https://www.cancer.gov/about-cancer/managing-care/financial-toxicity-hp-pdq.

  81. Hunter WG, Zhang CZ, Hesson A, Davis JK, Kirby C, Williamson LD, et al. Discuss to reduce out-of-pocket costs? Analysis of cost-saving strategies in 1,755 outpatient clinic visits. Med Decis Mak. 2016;36:900–10.

    Article  Google Scholar 

  82. Liu B, Chowdhury S, De Moor J, Kent E, Machlin S, Nutt S, et al. Evaluation of Strategies to Improve Utility of Estimates From a Non-probability Based Survey. Federal Committee on Statistical Methodology Research Conference; December 1–3, 2015. https://www.westat.com/aboutus/presentations/2015-federal-committee-statistical-methodology-fcsm-statistical-policy.

Download references

Author information

Authors and Affiliations

  1. Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA

    Matthew P. Banegas, John F. Dickerson, Alexandra Varga, Lisa Waiwaiole & Jennifer Schneider

  2. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA

    Erin E. Kent & Janet S. de Moor

  3. Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Katherine S. Virgo

  4. Division of Cancer Prevention and Control, U.S Centers for Disease Control and Prevention, Atlanta, GA, USA

    Gery P. Guy Jr. & Donatus U. Ekwueme

  5. Economics & Healthcare Delivery Research, American Cancer Society, Atlanta, GA, USA

    Zhiyuan Zheng

  6. School of Pharmacy, University of Maryland, Baltimore, MD, USA

    Zhiyuan Zheng

  7. The University of Texas, Austin, TX, USA

    Stephanie Nutt

  8. LIVESTRONG Foundation, Austin, TX, USA

    Loyce Pace

  9. Office of the Assistant Secretary for Planning and Evaluation, Washington, DC, USA

    K. Robin Yabroff

Authors
  1. Matthew P. Banegas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John F. Dickerson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erin E. Kent
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Janet S. de Moor
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Katherine S. Virgo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gery P. Guy Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Donatus U. Ekwueme
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zhiyuan Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Stephanie Nutt
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Loyce Pace
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Alexandra Varga
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Lisa Waiwaiole
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Jennifer Schneider
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. K. Robin Yabroff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthew P. Banegas.

Ethics declarations

This article does not contain any studies with human participants performed by any of the authors. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, or the Department of Health and Human Services.

Electronic supplementary material

ESM 1

(DOCX 40 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Banegas, M.P., Dickerson, J.F., Kent, E.E. et al. Exploring barriers to the receipt of necessary medical care among cancer survivors under age 65 years. J Cancer Surviv 12, 28–37 (2018). https://doi.org/10.1007/s11764-017-0640-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-017-0640-1

Keywords

Search

Navigation