25 October 2018

The "financial toxicity" of a cancer diagnosis

Excerpts from an article published in this month's edition of the American Journal of Medicine:
Approximately 15.5 million Americans have a history of cancer, with an estimated 1,688,780 new cases and 609,640 deaths annually. With 87% of diagnoses occurring in persons ≥50 years of age, cancer remains the second leading cause of death in the United States. Cancer's financial burden is often substantial during treatment phases and often worsens with improving prognoses.

With 6.5% of direct costs among nonelderly persons alone involving out-of-pocket payments, over half of all persons with cancer experienced house repossession, bankruptcy, loss of independence, and relationship breakdowns. Additionally, 40%-85% of cancer patients stop working during initial treatment, with absences ranging up to 6 months. Deductibles and copayments for treatment, supportive care, and nonmedical or indirect costs (eg, travel, caregiver time, and lost productivity) may be financially devastating even with healthcare coverage.

At year+2, 42.4% depleted their entire life's assets, with higher adjusted odds associated with worsening cancer, requirement of continued treatment, demographic and socioeconomic factors (ie, female, Medicaid, uninsured, retired, increasing age, income, and household size), and clinical characteristics (ie, current smoker, worse self-reported health, hypertension, diabetes, lung disease) (P<.05); average losses were $92,098. At year+4, financial insolvency extended to 38.2%, with several consistent socioeconomic, cancer-related, and clinical characteristics remaining significant predictors of complete asset depletion.
The American Journal of Medicine is peer-reviewed and is one of the most highly respected medical publications in the United States.  


  1. Could someone explain the subscripted +4 notation? In the last paragraph of the article's text?


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