Financial Toxicities Persist for Cancer Survivors Irrespective of Current Cancer Status: An Analysis of Medical Expenditure Panel Survey

This study estimates the out-of-pocket (OOP) expenditures for different cancer types among survivors with current versus no current cancer condition and across sex, which is understudied in the literature. This is a cross-sectional study of Medical Expenditure Panel Survey data for 2009–2018 where the primary outcome was the average per year OOP expenditure incurred by cancer survivors. Of 189,285 respondents, 15,010 (7.93%) were cancer survivors; among them, 46.28% had a current cancer condition. Average per year OOP expenditure for female survivors with a current condition of breast cancer ($1,730), lung cancer ($1,679), colon cancer ($1,595), melanoma ($1,783), non–Hodgkin lymphoma ($1,656), nonmelanoma/other skin cancer (NMSC, $2,118) and two or more cancers ($2,310) were significantly higher than that of women with no history of cancer ($853, all P < 0.05). Similarly, average per year OOP expenditure for male survivors with a current condition of prostate cancer ($1,457), lung cancer ($1,131), colon cancer ($1,471), melanoma ($1,474), non–Hodgkin lymphoma ($1,653), NMSC ($1,789), and bladder cancer ($2,157) were significantly higher compared with the men with no history of cancer ($621, all P < 0.05). These differences persisted in survivors with no current cancer condition for breast cancer among women; prostate, lung, colon, and bladder cancer among men; and melanoma, NMSC, and two or more cancers among both sexes. OOP expenditure varied across cancer types and by sex for survivors with and without a current cancer condition. These findings highlight the need for targeted interventions for cancer survivors. SIGNIFICANCE: Our study found that OOP expenditures among survivors with a current cancer condition for several cancers were significantly higher than that of individuals without a cancer history. These differences persisted in female with breast cancer; male with prostate, lung, colon, and bladder cancer; and survivors of both sexes with melanoma, and NMSC/other skin cancer, even after there was no current cancer condition.