Hidden cost of cancer survival: More bankruptcies

An analysis linking federal bankruptcy court records to cancer registry data from nearly 232,000 adult cancer cases in western Washington during a 14-year period has found a hidden cost to survival: Insolvency rates increase along with the length of survival.

“Patients diagnosed with cancer may face significant financial stress due to income loss and out-of-pocket costs associated with their treatment,” said study leader Dr. Scott Ramsey, a health care economist in the Public Health Sciences Division and Seattle Cancer Care Alliance physician. “On average, bankruptcy rates increased fourfold within five years of diagnosis.” Ramsey presented the findings June 6 at the 2011 annual meeting of the American Society of Clinical Oncology in Chicago.

Short median time to bankruptcy

The study found that compared to the general population, bankruptcy rates were nearly twice as high among cancer patients one year after diagnosis, and that the median time to bankruptcy was two and a half years after diagnosis.

“The risk of bankruptcy for cancer patients is not well known, and previous studies have relied on individual self-reports about medically related reasons for bankruptcy filing,” Ramsey said. “By linking two irrefutable government records of cancer and bankruptcy, we are able to determine how financial insolvency risk varies by cancer type, treatment, and other factors.”

For the study, Ramsey and PHS colleagues Kyle Snell, Catherine Fedorenko, and Drs. Polly Newcomb, Anne Kirchhoff, and David Blough linked Washington state cancer registry data with federal bankruptcy court records in 13 western Washington counties. They measured the rate of bankruptcy after a first cancer diagnosis and identified factors that increased bankruptcy risk among people with common cancers.

Factors affecting bankruptcy rates

They found that bankruptcy risk varies widely across cancer types. The risk is highest for lung, thyroid, and leukemia/lymphoma cancer patients. In contrast, patients over 65, who are typically on Medicare, have a much lower risk of bankruptcy than younger patients. The researchers also found that bankruptcy rates among cancer patients have increased significantly since the U.S. financial crisis.

The researchers conducted the study with University of Washington and University of Bristol colleagues, in collaboration with the U.S. Bankruptcy Court, Western District of Washington, Seattle.

The National Cancer Institute funded the research.