The long-term financial experiences of adolescent and young adult cancer survivors Journal Article


Authors: Thom, B.; Friedman, D. N.; Aviki, E. M.; Benedict, C.; Watson, S. E.; Zeitler, M. S.; Chino, F.
Article Title: The long-term financial experiences of adolescent and young adult cancer survivors
Abstract: Background: Cancer-related financial hardship can negatively impact financial well-being and may prevent adolescent and young adult (AYA) cancer survivors (ages 15–39) from gaining financial independence. This analysis explored the financial experiences following diagnosis with cancer among AYA survivors. Methods: We conducted a cross-sectional, anonymous survey of a national sample of AYAs recruited online. The Comprehensive Score for Financial Toxicity (COST) and InCharge Financial Distress/Financial Well-Being Scale (IFDFW) assessed financial hardship (cancer-related and general, respectively), and respondents reported related financial consequences and financial coping behaviors (both medical and non-medical). Results: Two hundred sixty-seven AYA survivors completed the survey (mean 8.3 years from diagnosis). Financial hardship was high: mean COST score was 13.7 (moderate-to-severe financial toxicity); mean IFDFW score was 4.3 (high financial stress). Financial consequences included post-cancer credit score decrease (44%), debt collection contact (39%), spending more than 10% of income on medical expenses (39%), and lacking money for basic necessities (23%). Financial coping behaviors included taking money from savings (55%), taking on credit card debt (45%), putting off major purchases (45%), and borrowing money (42%). In logistic regression models, general financial distress was associated with increased odds of experiencing financial consequences and engaging in both medical- and non-medical-related financial coping behaviors. Discussion: AYA survivors face long-term financial hardship after cancer treatment, which impacts multiple domains, including their use of healthcare and their personal finances. Interventions are needed to provide AYAs with tools to navigate financial aspects of the healthcare system; connect them with resources; and create systems-level solutions to address healthcare affordability. Implications for Cancer Survivors: Survivorship care providers, particularly those who interact with AYA survivors, must be attuned to the unique risk for financial hardships facing this population and make efforts to increase access available interventions. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Keywords: adolescent; adult; cancer survival; controlled study; young adult; neoplasm; neoplasms; cancer therapy; survivor; cancer survivor; survivors; survivorship; health care system; coping behavior; cross-sectional study; cross-sectional studies; income; cancer survivors; cancer survivorship; money; humans; human; article; financial toxicity; aya; financial distress; economic well-being; personal finance
Journal Title: Journal of Cancer Survivorship
Volume: 17
Issue: 6
ISSN: 1932-2259
Publisher: Springer  
Date Published: 2023-12-01
Start Page: 1813
End Page: 1823
Language: English
DOI: 10.1007/s11764-022-01280-2
PUBMED: 36472761
PROVIDER: scopus
PMCID: PMC9734817
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Bridgette Thom -- Source: Scopus
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MSK Authors
  1. Danielle Novetsky Friedman
    110 Friedman
  2. Bridgette Thom
    95 Thom
  3. Emeline Mariam Aviki
    81 Aviki
  4. Fumiko Chino
    224 Chino