The financial costs and consequences of cancer for patients and their families: a postal survey of patients with breast, lung, and prostate cancer in Ireland


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Aileen Timmons1, Linda Sharp1, Anne-Elie Carsin1, Noeleen Donnelly2, Joan Kelly2, John McCormack2, Niamh Ni Chonghaile2, Eileen O'Donnell3, Olywn Ryan2, Harry Comber1

1National Cancer Registry Ireland, Cork, Ireland, 2Irish Cancer Society, Dublin, Ireland, 3St Vincent's Hospital, Dublin, Ireland

Abstract

Proffered paper presentation

Background
Awareness is increasing that cancer can have an adverse financial and economic impact for patients and their families. To date, relatively few large-scale studies have been conducted. We aimed to: (1) quantify the proportion of patients incurring cancer-related additional expenditure or financial difficulties; (2) identify vulnerable patient sub-groups; and (3) assess financial consequences.

Method
A questionnaire was developed from literature review and qualitative interviews with key informants and cancer survivors. Topics included: extra expenses incurred, impact of cancer on income, household ability to make ends meet, and concerns about household financial situation. The questionnaire was mailed to individuals who had breast, lung or prostate cancer diagnosed within the previous 18 months, identified through the National Cancer Registry Ireland.

Results
740 completed questionnaires were received (response rate=54%). Respondents had direct medical costs due to consultant visits (45%), GP visits (36%), physiotherapy (9%), counselling (6%), and other therapies (2%). Treatment-related travel costs were incurred by 71% and 52% paid for hospital parking. Approximately 60% reported increased household bills due to their cancer diagnosis. Almost one-third reported decreased income. The consequences of the additional expenses and decreased income included: using savings (55%); borrowing money (11%); difficulties meeting mortgage (43%) and personal loan (57%) payments; and reduced spending on extras (21%). One third were more concerned about their household's financial situation; this did not vary by socio-demographic characteristics. For 48% the cancer diagnosis had made it more difficult for their household to make ends meet. This percentage was higher among patients who were younger, of working age or had dependents.

Conclusion
Most patients incur extra expenses as a result of cancer, and many experience a drop in income. The consequences for patients and their families are wide-ranging. These findings have important implications for patient support organizations, health and social services, and policy makers.