Cancer's Toll Beyond the Disease: Medical Costs and Productivity

With nearly 18 million estimated survivors by 2022, cancer care in the United States needs a coordinated agenda to be successfully able to address the long-term medical as well as economic needs of survivors. Highlighting the economic burden on survivors is a new report from the American Cancer Society, published in the Journal of the National Cancer Institute, which found that younger colorectal cancer survivors end up spending over $8500 annually in medical expenses and they also experience significantly greater loss of productivity compared with individuals without cancer.

Evaluating the impact of medical costs on survivors of 3 cancers: colorectal, female breast, and prostate, researchers from the American Cancer Society segregated the elderly and the younger population of survivors. Using data gathered by the Medical Expenditure Panel Survey—a national data source that measures use and costs of medical care, health insurance, and out-of-pocket spending in the United States—between 2008 and 2012, the study included 540 colorectal cancer survivors, 1568 female breast cancer survivors, 1170 prostate cancer survivors, and 109,423 individuals without cancer. They compared the excess economic pressures that survivors experienced due to their disease, as well as loss of productivity associated with taking time off from work.

Young cancer survivors included in the study witnessed a significant impact of cancer on their annual medical expenses as well as on their productivity at work. Those who survived colorectal cancer had an average excess of $8647 in medical costs; breast cancer survivors, $5119; and prostate cancer survivors, $3586. Costs were relatively lower for the elderly survivors, but greater nonetheless than the comparator population: $4913 for colorectal, $2288 for breast, and $3524 for prostate.

Younger survivors of colorectal and breast cancer had significantly greater employment disability (13.6% and 4.8%, respectively) compared with those without cancer. They also lost more work days: 7.2 days on average for colorectal cancer survivors and 3.3 days for breast cancer survivors. Surprisingly, the elderly population included in the study had comparable productivity losses as those without a history of cancer in their age group.

These results indicate that survivors continue to experience disease-related symptoms even after being declared disease-free, but are forced to get back to work, likely due to monetary needs and to maintain health insurance coverage. A National Cancer Institute—funded study at the Massey Cancer Center at Virginia Commonwealth University has been investigating the impact of provisions within the Affordable Care Act (ACA) that can help individuals who depend on employer-sponsored health insurance. Preliminary results have indicated that with the ACA, cancer patients will not have to worry about loss of insurance coverage if they can no longer work. This would allow survivors to focus on their path to recovery and improve their quality of life.