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Health Aff (Millwood). 2016 Jan;35(1):54-61. doi: 10.1377/hlthaff.2015.0830.

For Working-Age Cancer Survivors, Medical Debt And Bankruptcy Create Financial Hardships.

Author information

Matthew P. Banegas ( is an investigator at the Kaiser Permanente Center for Health Research, in Portland, Oregon.
Gery P. Guy Jr. is a health economist at the Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia.
Janet S. de Moor is a program director in the Division of Cancer Control and Population Sciences, at the National Cancer Institute (NCI), in Bethesda, Maryland.
Donatus U. Ekwueme is a senior health economist at the CDC.
Katherine S. Virgo is an adjunct professor in the Department of Health Policy and Management at Emory University, in Atlanta.
Erin E. Kent is an epidemiologist and program director in the Outcomes Research Branch, Applied Research Program, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, at the NCI.
Stephanie Nutt is a program manager at the LIVESTRONG Foundation, in Austin, Texas.
Zhiyuan Zheng is a senior epidemiologist at the American Cancer Society in Atlanta, Georgia.
Ruth Rechis is vice president of programs and strategy at the LIVESTRONG Foundation.
K. Robin Yabroff is an epidemiologist in the Division of Cancer Control and Population Sciences at the NCI.


The rising medical costs associated with cancer have led to considerable financial hardship for patients and their families in the United States. Using data from the LIVESTRONG 2012 survey of 4,719 cancer survivors ages 18-64, we examined the proportions of survivors who reported going into debt or filing for bankruptcy as a result of cancer, as well as the amount of debt incurred. Approximately one-third of the survivors had gone into debt, and 3 percent had filed for bankruptcy. Of those who had gone into debt, 55 percent incurred obligations of $10,000 or more. Cancer survivors who were younger, had lower incomes, and had public health insurance were more likely to go into debt or file for bankruptcy, compared to those who were older, had higher incomes, and had private insurance, respectively. Future longitudinal population-based studies are needed to improve understanding of financial hardship among US working-age cancer survivors throughout the cancer care trajectory and, ultimately, to help stakeholders develop evidence-based interventions and policies to reduce the financial hardship of cancer.


Bankrucpty; Cancer; Financial hardship; LIVESTRONG; Medical debt

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