Hammarlund Noah, Jacobs Molly
Department of Health Services Research, Management & Policy, University of Florida, PO Box 100195, Gainesville, FL, 32610, USA.
J Cancer Surviv. 2025 Jun 5. doi: 10.1007/s11764-025-01817-1.
Financial toxicity (FT) represents a significant challenge for cancer survivors, disproportionately affecting racial and ethnic minorities. This study examines income and wealth changes among cancer survivors and explores the implications for survivorship care equity.
We analyzed longitudinal cohort data from the Medical Expenditure Panel Survey (2018-2021) to examine how cancer diagnoses (prostate, colon, lung, or breast cancer) affect income and wealth. Fixed effects regression controlled for unobserved individual differences, isolating the impact of cancer. We used interaction terms to explore racial and ethnic disparities and applied Heckman models to test the robustness of the results to potential selection bias.
Of the 5409 respondents, 229 (4.23%) reported a diagnosis of one of the targeted cancers. Cancer diagnosis was associated with a 14.44 percentage point reduction in income and a 15.94 percentage point reduction in wealth. Hispanic cancer survivors saw a 42.27 percentage point reduction in income and 36.83 percentage points in wealth, while Black cancer survivors saw reductions of 20.99 percentage points in income and 19.98 percentage points in wealth. These disparities persisted across different model specifications.
This study provides robust estimates of the financial impact of cancer, revealing significant and disproportionate financial burdens among Black and Hispanic survivors. These findings underscore the need for integrating financial health assessments into survivorship care to address inequities and improve quality of life.
Our findings indicate that cancer is associated with significant reductions in income and wealth, with disproportionate burdens observed among Black and Hispanic survivors. These results highlight the need for greater attention to financial well-being in survivorship care, especially for systemically marginalized groups.
经济毒性（FT）对癌症幸存者来说是一项重大挑战，对少数族裔的影响尤为严重。本研究调查了癌症幸存者的收入和财富变化，并探讨了其对生存护理公平性的影响。
我们分析了医疗支出面板调查（2018 - 2021年）的纵向队列数据，以研究癌症诊断（前列腺癌、结肠癌、肺癌或乳腺癌）如何影响收入和财富。固定效应回归控制了未观察到的个体差异，分离出癌症的影响。我们使用交互项来探讨种族和民族差异，并应用赫克曼模型来检验结果对潜在选择偏差的稳健性。
在5409名受访者中，229人（4.23%）报告被诊断患有一种目标癌症。癌症诊断与收入降低14.44个百分点和财富降低15.94个百分点相关。西班牙裔癌症幸存者的收入降低了42.27个百分点，财富降低了36.83个百分点，而黑人癌症幸存者的收入降低了20.99个百分点，财富降低了19.98个百分点。这些差异在不同的模型设定中都持续存在。
本研究对癌症的经济影响提供了可靠的估计，揭示了黑人和西班牙裔幸存者面临的巨大且不成比例的经济负担。这些发现强调了将财务健康评估纳入生存护理以解决不平等问题并改善生活质量的必要性。
我们的研究结果表明，癌症与收入和财富的显著减少相关，在黑人和西班牙裔幸存者中观察到了不成比例的负担。这些结果凸显了在生存护理中更加关注财务状况的必要性，特别是对于系统性边缘化群体。
