Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.
Fred Hutchinson Cancer Center, Seattle, Washington, USA.
Cancer. 2024 Apr 1;130(7):1125-1136. doi: 10.1002/cncr.35150. Epub 2023 Dec 15.
Siblings of children with cancer may experience adverse household economic consequences, but their financial outcomes in adulthood are unknown.
A total of 880 siblings (aged 18-64 years) of adult-aged childhood cancer survivors were surveyed to estimate the prevalence of financial hardship by three established domains (behavioral, material, and psychological). For individual financial hardship items matching the contemporaneous National Health Interview Survey or Behavioral Risk Factor Surveillance System, siblings were compared with the general population by calculating adjusted prevalence odds ratios (ORs) to sample-weighted responses. Multivariable logistic regression models examined associations between sibling characteristics and each hardship domain and between sibling hardship and survivors' cancer/treatment characteristics.
Behavioral, material, and psychological hardship was reported by 24%, 35%, and 28%, respectively. Compared with national survey respondents, siblings were more likely to report worries about medical bills (OR, 1.14; 95% confidence interval [CI], 1.06-1.22), difficulty affording nutritious foods (OR, 1.79; 95% CI, 1.54-2.07), and forgoing needed medical care (OR, 1.38; 95% CI, 1.10-1.73), prescription medications (OR, 2.52; 95% CI, 1.99-3.20), and dental care (OR, 1.34; 95% CI, 1.15-1.57) because of cost. Sibling characteristics associated with reporting financial hardship in one or more domains included female sex, older age, chronic health conditions, lower income, not having health insurance, high out-of-pocket medical expenditures, and nonmedical/nonhome debt. No survivor cancer/treatment characteristics were associated with sibling financial hardship.
Adult siblings of childhood cancer survivors were more likely to experience financial hardship compared with the general population. Childhood cancer may adversely affect entire households, with potentially lasting implications.
癌症患儿的兄弟姐妹可能会经历家庭经济方面的不良后果，但他们成年后的财务状况尚不清楚。
共调查了 880 名成年癌症幸存者的兄弟姐妹（年龄在 18-64 岁之间），以根据三个既定领域（行为、物质和心理）估计经济困难的发生率。对于与同期国家健康访谈调查或行为风险因素监测系统相匹配的个人经济困难项目，通过计算调整后的患病率比值比（OR）与样本加权的应答进行比较，以确定兄弟姐妹与一般人群之间的差异。多变量逻辑回归模型检查了兄弟姐妹特征与每个困难领域之间的关系，以及兄弟姐妹的困难与幸存者的癌症/治疗特征之间的关系。
分别有 24%、35%和 28%的兄弟姐妹报告了行为、物质和心理方面的困难。与全国调查受访者相比，兄弟姐妹更有可能报告担心医疗费用（OR，1.14；95%置信区间[CI]，1.06-1.22）、难以负担营养食品（OR，1.79；95% CI，1.54-2.07）、放弃必要的医疗保健（OR，1.38；95% CI，1.10-1.73）、处方药（OR，2.52；95% CI，1.99-3.20）和牙科保健（OR，1.34；95% CI，1.15-1.57）的费用。与报告一个或多个领域经济困难相关的兄弟姐妹特征包括女性、年龄较大、慢性健康状况、较低的收入、没有医疗保险、较高的自付医疗支出以及非医疗/非住房债务。幸存者癌症/治疗特征与兄弟姐妹的经济困难无关。
与一般人群相比，儿童癌症幸存者的成年兄弟姐妹更有可能经历经济困难。儿童癌症可能会对整个家庭产生不利影响，可能会产生持久的影响。
