Wilsnack Catherine, Cubbin Catherine
Steve Hicks School of Social Work, University of Texas at Austin, 405 W 25th St, Austin, TX, 78705, USA.
J Cancer Surviv. 2024 Nov 29. doi: 10.1007/s11764-024-01707-y.
The present study examined the association between race/ethnicity and medical financial hardship between cancer survivors aged 18-64 years who were diagnosed when they were adolescents or young adults (AYAs, aged 15-39 years old) and non-AYAs (aged 40-64 years old).
We used data from the 2013-2018 National Health Interview Survey (NHIS) to identify AYA cancer survivors who were defined as receiving a cancer diagnosis between 15 and 39 years old and non-AYA cancer survivors who were defined as receiving a cancer diagnosis between 40 and 64 years old. Medical financial hardship was defined by 3 hardship domains: material (e.g., difficulty paying off medical bills), psychological (e.g., worry about medical costs), and behavioral (e.g., not receiving/postponing care because of cost).
There were 2162 AYA cancer survivors (mean age = 32 years) and 3393 non-AYA cancer survivors (mean age = 51 years). AYA cancer survivors were more likely than non-AYA cancer survivors to experience all 3 hardship domains (30% vs. 20%, P < 0.01). Hispanic AYA and non-AYA cancer survivors had increased odds for experiencing any psychological hardship compared to White counterparts (P < 0.05). Black non-AYA cancer survivors had increased odds for experiencing any material hardship (P < 0.05).
Race/ethnicity was associated with some domains of medical financial hardship for Black and Hispanic cancer survivors. AYA cancer survivors also experienced more domains of medical financial hardship compared to non-AYA cancer survivors.
Direct practice and policy-level interventions are needed to address financial disparities among cancer survivors. Future research should examine disaggregated racial data.
本研究调查了18 - 64岁癌症幸存者中种族/族裔与医疗经济困难之间的关联，这些幸存者在青少年或青年时期（青少年和青年成人，15 - 39岁）被诊断出癌症，以及非青少年和青年成人癌症幸存者（40 - 64岁）。
我们使用了2013 - 2018年全国健康访谈调查（NHIS）的数据，以确定被定义为在15至39岁之间被诊断出癌症的青少年和青年成人癌症幸存者，以及被定义为在40至64岁之间被诊断出癌症的非青少年和青年成人癌症幸存者。医疗经济困难由三个困难领域定义：物质方面（例如，难以支付医疗账单）、心理方面（例如，担心医疗费用）和行为方面（例如，因费用问题未接受/推迟治疗）。
有2162名青少年和青年成人癌症幸存者（平均年龄 = 32岁）和3393名非青少年和青年成人癌症幸存者（平均年龄 = 51岁）。青少年和青年成人癌症幸存者比非青少年和青年成人癌症幸存者更有可能经历所有三个困难领域（30%对20%，P < 0.01）。与白人相比，西班牙裔青少年和青年成人癌症幸存者以及非青少年和青年成人癌症幸存者经历任何心理困难的几率增加（P < 0.05）。黑人非青少年和青年成人癌症幸存者经历任何物质困难的几率增加（P < 0.05）。
种族/族裔与黑人和西班牙裔癌症幸存者的一些医疗经济困难领域相关。与非青少年和青年成人癌症幸存者相比，青少年和青年成人癌症幸存者也经历了更多的医疗经济困难领域。
需要直接的实践和政策层面的干预措施来解决癌症幸存者之间的经济差距。未来的研究应该检查分类的种族数据。
