RTI International, Research Triangle Park, NC, USA.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Cancer Causes Control. 2020 Nov;31(11):1001-1009. doi: 10.1007/s10552-020-01334-9. Epub 2020 Sep 8.
Breast cancer is the leading cause of cancer-related deaths in women younger than 40 years. We aim to evaluate cost as a barrier to care among female breast cancer patients diagnosed between 18 to 39 years.
In early 2017, we distributed a survey to women diagnosed with breast cancer between the ages of 18 and 39 years, as identified by the central cancer registries of California, Georgia, North Carolina, and Florida. We used multivariable statistics to explore cost-related barriers to receiving breast cancer care for the 830 women that completed the survey.
About half of the women (47.4%) reported spending more on breast cancer care than expected, and almost two-thirds (65.3%) had not discussed costs with their care team. A third of the patients (31.8%) indicated forgoing care due to cost. Factors associated with not receiving anticipated care due to cost included age less than35 years at diagnosis, self-insurance, comorbid conditions, and late-stage diagnosis.
Previous studies using breast cancer registry data have not included detailed insurance information and care received by young women. Young women with breast cancer frequently forgo breast cancer care due to cost. Our results highlight the potential for policies that facilitate optimal care for young breast cancer patients which could include the provision of comprehensive insurance coverage.
乳腺癌是导致 40 岁以下女性癌症相关死亡的主要原因。我们旨在评估年轻女性乳腺癌患者（18-39 岁）的护理费用障碍。
2017 年初，我们向加利福尼亚州、佐治亚州、北卡罗来纳州和佛罗里达州中央癌症登记处确定的 18 至 39 岁之间被诊断患有乳腺癌的女性分发了一份调查。我们使用多变量统计方法，对完成调查的 830 名女性接受乳腺癌护理的成本相关障碍进行了分析。
约一半的女性（47.4%）报告在乳腺癌护理上的花费超出预期，近三分之二（65.3%）没有与护理团队讨论过费用问题。三分之一的患者（31.8%）因费用而放弃了治疗。因费用而未接受预期治疗的因素包括诊断时年龄小于 35 岁、自我保险、合并症和晚期诊断。
之前使用乳腺癌登记数据的研究没有包括年轻女性的详细保险信息和接受的护理。患有乳腺癌的年轻女性经常因费用而放弃乳腺癌治疗。我们的研究结果强调了制定政策的潜力，这些政策可以为年轻的乳腺癌患者提供最佳护理，其中可能包括提供全面的保险覆盖。
