ASPO Abstracts
Insurance coverage, employment status and financial well-being of young women diagnosed with breast cancer
Category: Financial Hardship Associated with Cancer
Conference Year: 2020
Abstract Body:
Purpose of the study: This study aims to evaluate the insurance, employment, and financial experiences of young
female breast cancer survivors and assess factors associated with financial decline.
Methods: We recruited 830 women under 40 years of age diagnosed with breast cancer between January 2013
and December 2014. The study population was identified through California, Florida, Georgia, and North Carolina
population-based cancer registries. The cross-sectional survey was fielded in 2017 and included questions on
demographics, insurance, employment, out-of-pocket costs, and financial well-being. We present descriptive
statistics and multivariate analysis to assess factors associated with financial decline.
Results: Although 92.5% of the respondents were continuously insured over the past 12 months, 9.5% paid a
"higher price than expected" for coverage. Common concerns among the 73.4% of respondents who were
employed at diagnosis included increased paid (55.1%) or unpaid (47.3%) time off, suffering job performance
(23.2%), and staying at (30.2%) or avoiding changing jobs (23.5%) for health insurance purposes. Overall, 47.0%
experienced financial decline due to treatment-related costs. Patients with some college education, multiple
comorbidities, late stage diagnoses, and self-funded insurance were most vulnerable.
Conclusions: The breast cancer diagnosis created financial hardship for half the respondents and led to myriad
challenges in maintaining employment. Employment decisions were heavily influenced by the need to maintain
health insurance coverage.
Impact: This study finds that a breast cancer diagnosis in young women can result in employment disruption and
financial decline.
Keywords: Breast Cancer, Insurance, Affordability, Surveys, Registries