Cancer survivors spend more on health care

Those who are treated for and survive cancer are susceptible to later health complications and their total medical expenses average about $9,300 per year. People are considered cancer survivors from the moment they are diagnosed through the end of their lives. Advances in medicine enable more people to survive cancer, but there is little information regarding long-term health and economic effects of cancer.

"The fact that so many more people are surviving for a long time has shifted the attention of the oncology community -- as well as public health officials -- away from a focus simply on treatment and keeping people alive. Now they are starting to think about life after cancer," said Pamela Farley Short, professor of health policy and administration. Short and her colleagues report their work in the current issue of Cancer.

Short and her colleagues focused their research on cancer survivors ranging in age from 25 through 64 years. Prior to their study, most information regarding cancer survivors concentrated on patients 65 years and older, relying on data from Medicare. The new study uses national data from the Medical Expenditure Panel Survey (MEPS) and improves on earlier survivor studies based on that survey, which were limited to survivors who received care specifically for cancer in any given year. The researchers linked MEPS to another data source to systematically identify everyone in the survey who had ever been diagnosed with cancer.

"Then we went through an analytic exercise of matching up cancer survivors to otherwise similar people in the survey who don't have a history of cancer," said Short. "The question we're trying to answer is, how much did the fact of having cancer add to the expenditures of cancer survivors? If they hadn't had cancer, how much less would their annual health care bills be and how much less would they be spending out of pocket?"

Earlier studies analyzing MEPS provided an incomplete picture of cancer survivors.

"We made the effort to do it right, and found the earlier estimates were off," said Short. Of the people identified as cancer survivors in the research conducted by Short and her colleagues, 53 percent were missed in earlier studies. Consequently the researchers were able to learn more about cancer survivors and their health care spending.

The researchers found that as a group, cancer survivors in the U.S. are disproportionately women, non-Hispanic whites, unmarried -- single, divorced or widowed -- and publicly insured. However, men paid 16 percent of cancer-related increases in health care out of pocket, and women paid 9 percent. According to Short, the largest out-of-pocket expense for survivors is prescriptions.

"This research is also important because cancer survivors are a sympathetic group for calling attention to the challenges that many people face in paying for health care," said Short. "Almost everybody has a friend or someone in their family who's had cancer, so it resonates. In a way, I think cancer survivors are poster children for a lot of the issues that we face as a society in considering whether and how to proceed with health care reform."

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