A cancer diagnosis can lead to a cascade of challenges, and new research reveals a significant link between the financial turmoil that follows and a patient’s chances of survival. A decline in credit score, a key indicator of financial health, is emerging as a powerful predictor of increased mortality risk among cancer patients. This connection highlights a growing concern in oncology known as “financial toxicity,” where the high cost of care creates a debilitating burden that can ultimately impact clinical outcomes.
The financial strain of a cancer diagnosis is not a new phenomenon, but the use of objective financial data, such as credit reports, provides a clearer picture of the problem. Studies show that individuals diagnosed with cancer are more likely to face bankruptcy, debt collections, and a persistent drop in their credit scores that can last for years. This financial distress is not just a matter of economic hardship; it appears to be a critical factor in a patient’s ability to navigate their treatment journey and, ultimately, survive their disease.
The Widespread Financial Fallout of Cancer
The financial consequences of a cancer diagnosis can be both immediate and long-lasting. Research utilizing large-scale, real-world data has painted a stark picture of the financial burdens faced by patients. One study, which compared Experian credit bureau data from over 99,000 cancer patients with nearly 189,000 people without cancer, found that patients with cancer had significantly lower credit scores—by an average of nearly 80 points. This drop in creditworthiness was not a temporary setback; the study noted that these lower scores persisted for up to 9.5 years after the initial diagnosis.
Beyond credit scores, the research revealed higher rates of total debt collections, medical collections, and bankruptcies among cancer patients. In fact, patients with cancer were found to be almost five times more likely to experience bankruptcy compared to their non-cancer counterparts. These findings are consistent with other research that has shown cancer patients are more than twice as likely to declare bankruptcy as those without a cancer diagnosis. The accumulation of medical debt is a primary driver of this financial distress. National Cancer Institute data indicates that the average annual cost of cancer care can be as high as $43,516 in the initial year after diagnosis and nearly $110,000 in the last year of life. This financial burden is often exacerbated by a reduced ability to work, leading to lost income for both patients and their caregivers.
Connecting Financial Hardship to Survival Rates
The link between financial health and mortality in cancer patients is becoming increasingly clear. A study by the American Cancer Society presented at the American Society of Clinical Oncology (ASCO) annual meeting found that pre-diagnosis adverse financial events (AFEs), such as bankruptcy, liens, or evictions, were associated with an increased risk of both all-cause and cancer-specific mortality for several types of cancer. The study analyzed data from 58,796 individuals and found that the 36.9% who had a pre-diagnosis AFE faced a higher mortality risk. This connection held true for patients with female breast, colorectal, oral cavity/pharynx, and prostate cancer, as well as melanoma.
Another study further solidified this connection, finding that individuals who declared bankruptcy after a cancer diagnosis were 80% more likely to die than those who did not. This suggests that financial distress, whether it precedes or follows a diagnosis, can have a profound impact on a patient’s outcome. The mechanisms behind this link are likely multifaceted, involving a combination of factors such as increased stress, reduced access to care, and difficulties adhering to treatment regimens due to cost-related barriers.
Factors That Amplify Financial Toxicity
The degree of financial toxicity can vary significantly depending on the type of cancer and the treatments received. Certain cancers are associated with a greater financial burden and a more significant drop in credit scores. Research has identified bladder, liver, lung, and colorectal cancers as having a more pronounced negative impact on patients’ financial health. This may be due to a combination of factors, including the costs of treatment, the need for more frequent surveillance, and the overall prognosis associated with these diseases.
The type of treatment a patient undergoes also plays a crucial role. A study focusing on colorectal cancer patients found that those who received only radiation therapy had credit scores 62 points lower than those who had surgery alone. Patients who underwent chemotherapy had scores 14 points lower than the surgery-only group. This suggests that treatments like chemotherapy and radiation, which can be prolonged and expensive, are more “financially toxic” than surgery alone. The combination of different therapies can further compound the financial strain on patients.
A New Era of Research: Linking Registries and Credit Data
The latest insights into financial toxicity are the result of innovative research methods that link large-scale cancer registries with credit records. By connecting data from sources like the SEER cancer registry with credit bureaus such as TransUnion and Experian, researchers can move beyond subjective patient surveys to obtain objective, real-world evidence of financial hardship. This approach provides a more concrete and quantifiable understanding of the financial challenges faced by cancer patients and survivors. For instance, a population-based study in Western Washington used this method to compare patients from the SEER registry with a control group from voter registries, confirming that patients with cancer had a significantly higher risk of AFEs and past-due credit payments.
These studies, which involve tens of thousands of patients, offer a powerful and comprehensive view of the financial landscape for individuals with cancer. By analyzing objective financial markers, researchers can identify patterns and risk factors that might not be apparent from self-reported data alone. This data-driven approach is crucial for developing targeted interventions and support systems to help mitigate the financial burden on patients.
Implications for Patient Care and the Healthcare System
The growing body of evidence linking financial distress to mortality underscores the need for the healthcare system to address financial toxicity as a critical component of cancer care. Experts are increasingly calling for healthcare providers to screen for and address patients’ health-related social needs, including financial vulnerability. By identifying patients at risk of severe financial hardship early on, healthcare teams can connect them with resources such as financial navigators and patient support groups to help them manage debt and credit issues.
The findings also highlight the need for further research to understand the precise ways in which financial events impact treatment decisions, quality of life, and clinical outcomes. As the number of cancer survivors continues to grow, projected to reach 20.3 million by 2026, the long-term financial consequences of a cancer diagnosis will become an even more pressing issue. Addressing financial toxicity is not just about improving patients’ economic well-being; it is a crucial step toward ensuring that all patients have the best possible chance of survival.