BALANCE SHEET APPROACH TO FINANCIAL DEBT AND ASSETS IN CANCER SURVIVORS

Purpose:   To characterize and assess the effect of cancer and its treatment on the finances of cancer survivors, compared to individuals without a cancer history, by describing the total assets and debt, as well as estimating net worth, debt-to-asset and debt-to-income ratios. Our overarching aim is to see if the long-run ‘Financial Toxicity’ of cancer treatment affects the balance sheet of cancer survivors compared to people without a cancer diagnosis. 

Method:  Longitudinal panels of the Medical Expenditure Panel Survey (MEPS) 2008-2011 household component were utilized to identify adult patients who had a history of cancer along with the MEPS asset section to explore their financial status. An individual’s net worth was derived from financial assets plus the net value of property, business equity, vehicles and other savings minus debt. To capture the effect of the cancer diagnosis, adjusted generalized linear models (GLM) were run to find average partial effects of having a history of a cancer diagnosis on financial outcome measures, stratifying by age.

Result: In this MEPS sample, 3,230 cancer survivors met our inclusion criteria and had very different demographic baseline characteristics than the control group of adults without a history of cancer. Survivors were older, more likely to be white, non-Hispanic, not in employment and have higher numbers of comorbid conditions  Stratifying by age, showed that debt ownership was only statistically significance in the younger age group (18-34yrs) with a mean debt amount of $4,897 (95%CI: $1,612-$8,182) compared to $2,937 (95%CI: $2,724-$3,150). With asset ownership and net worth as the outcome measures, it was observed that in older age groups (55yrs+), the mean values were higher in cancer survivor groups.  However, once the covariates are accounted for in the GLM model, average marginal decrement effect of a cancer diagnosis on net worth in those aged between 45-64 years of age was seen to be $19,390-23,681 compared to their peers.

Conclusion: The ‘financial toxicity’ of cancer care is likely to be seen in younger, working-age adults. Medical debt is more acutely felt in the 25-34 years old age group and decrease in net-worth in the 45-64 years old age group.