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Cancer diagnosis associated with increased risk of adverse financial events


Cancer patients are at a higher risk of negative financial effects than those who have not been diagnosed.

Adverse financial events (AFEs) and late credit card payments have been found to be more common in patients diagnosed with cancer, although more information is needed to determine how this relates to treatment decisions and to quality of life, according to a study. published in the Journal of Clinical Oncology.

When age, sex, mean baseline credit, area deprivation index, and year of diagnosis were adjusted, cancer patients had a higher risk of EA (OR, 1, 71, 95% CI, 1.61-1.81; P

A total of 190,722 patients were identified in either of the western Washington SEER cancer registries and included 63,574 cases and a random sample from known voter registries as controls of 127,148.

More patients in the case group had an unknown area deprivation index compared to the control group. Notably, the distribution of cases and controls across the different deprivation index categories in the area was similar, although a small proportion of individuals in both groups resided in high deprivation index neighborhoods. A lower available credit base was observed in the case group, with an average average line of credit of $12,486. A total of 13.8% of patients were black.

At 24 months, there was evidence of a greater number of EFAs (4.3% vs. 2.4%; P credit card payment arrears (2.6% vs. 1.9%; P <.0001 in the case group compared to control group. additionally more patients who were black experienced afe than those not vs.>P <.0001 in the case group vs control respectively.>

The most common TFAs were third-party collections, write-offs, and overdue mortgage payments. However, seizures and foreclosures were less common. In the case group, all events were more frequent except seizures and liens which were rare and not significantly higher in the cancer population.

Patients who had been diagnosed with cancer were associated with all types of EFA severity after adjustment, including severe EFA (OR, 1.87; 95% CI, 1.76-1.99) , the most severe AFE (OR, 1.23; 95% CI, 1.08-1.40), and the most severe AFE (OR, 1.45; 95% CI, 1.04-2, 02). A subgroup of cancer survivors at 5 years with matched controls showed that a greater proportion of both groups experienced EFAs, but those with cancer remained at increased risk at 9.0% and 6 .1% in the control group (OR, 1.41; 95% CI, 1.32-1.50; P <.0001>

Sensitivity analysis revealed that the mean number of prior EFAs was 0.26 in the case group versus 0.16 in the control group. Patients in the case group had a lower baseline available credit of $9,716 compared to $11,136 in the control group (P <.0001>

Additionally, a separate analysis was conducted that included patients who died within 24 months of diagnosis. The analysis found that 5.3% of cancer patients had EFAs after diagnosis, compared to 4.3% of those with cancer who survived after 24 months. Logistic regression analysis revealed that people with cancer had an increased risk of EA compared to controls (OR, 2.19; 95% CI, 2.1-2.3; P <.0001>


Shankaran V, Li L, Fedorenko C, et al. Risk of adverse financial events in cancer patients: evidence from a new link between the cancer registry and credit records. J Clin Oncol. 2022;40(8):884-891. doi:10.1200/JCO.21.01636