Doroudi Maryam, Coughlan Diarmuid, Banegas Matthew P, Han Xuesong, Yabroff K Robin
Early Detection Branch, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD.
Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD.
JNCI Cancer Spectr. 2018 Apr 20;2(2):004. doi: 10.1093/jncics/pky004. eCollection 2018 Apr.
Financial hardships experienced by cancer survivors have become a prominent public health issue in the United States. Few studies of financial hardship have assessed financial holdings, including assets, debts, and their values, associated with a cancer history.
Using the 2008-2011 Medical Expenditure Panel Survey, we identified 1603 cancer survivors and 34 915 individuals age 18-64 years without a cancer history to assess associations between self-reported cancer history and assets, debts, and net worth. Distributions of self-reported asset and debt ownership, their values, and net worth were compared for adults with and without a cancer history with chi-square statistics. Multivariable ordered probit regression analysis was conducted to assess the association between cancer history and net worth using a two-sided Wald test. All analyses were stratified by age group (18-34, 35-44, 45-54, and 55-64 years). Statistical tests were two-sided.
Among those age 45-54 years, cancer survivors had a lower proportion of home ownership than individuals without a cancer history (59.0% vs 67.1%, = .0014) and were statistically significantly more likely to have negative net worth (≤-$3000) and less likely to have positive net worth (≥$3000). Cancer survivors were more likely to have debt than individuals without a cancer history, especially among those age 18-34 years (41.3% vs 27.1%, < .001).
Cancer history is associated with lower asset ownership, more debt, and lower net worth, especially in survivors age 45-54 years. Longitudinal studies of financial holdings will be important to inform development of interventions to reduce financial hardship.
癌症幸存者所经历的经济困难已成为美国一个突出的公共卫生问题。很少有关于经济困难的研究评估过与癌症病史相关的金融资产，包括资产、债务及其价值。
利用2008 - 2011年医疗支出小组调查，我们确定了1603名癌症幸存者和34915名年龄在18 - 64岁且无癌症病史的个体，以评估自我报告的癌症病史与资产、债务和净资产之间的关联。使用卡方统计量比较了有和没有癌症病史的成年人自我报告的资产和债务所有权分布、其价值和净资产。采用多变量有序概率回归分析，使用双侧Wald检验评估癌症病史与净资产之间的关联。所有分析按年龄组（18 - 34岁、35 - 44岁、45 - 54岁和55 - 64岁）分层。统计检验为双侧检验。
在45 - 54岁的人群中，癌症幸存者拥有住房的比例低于无癌症病史的个体（59.0%对67.1%，P = 0.0014），并且在统计学上显著更有可能拥有负净资产（≤ - 3000美元），而拥有正净资产（≥ 3000美元）的可能性较小。癌症幸存者比无癌症病史的个体更有可能背负债务，尤其是在18 - 34岁的人群中（41.3%对27.1%，P < 0.001）。
癌症病史与较低的资产拥有率、更多的债务和较低的净资产相关，尤其是在45 - 54岁的幸存者中。对金融资产的纵向研究对于为减少经济困难的干预措施的制定提供信息将很重要。
