Many survivors of adolescent and young adult cancers avoid routine
medical care because it’s too expensive, despite the fact that most have
health insurance. That is the conclusion of a new study published early
online in CANCER, a peer-reviewed journal of the American Cancer
Society. The results indicate that expanding insurance coverage for
young cancer survivors may be insufficient to safeguard their long-term
health without efforts to reduce their medical cost burdens.
Medical care in the years after a cancer diagnosis is particularly
important for detecting any long-term health conditions associated with
their cancer treatment; however, little is known about the extent of
care that survivors of adolescent and young adult cancers receive in the
years after their diagnosis and treatment.
To investigate, Anne Kirchhoff, PhD, MPH, of Huntsman Cancer Institute
at the University of Utah in Salt Lake City, and her colleagues analyzed
national survey responses from younger adults ages 20-39 years: 979 who
were diagnosed with cancer between the ages of 15 to 34 years and were
at least five years from diagnosis, compared with 67,216 controls who
had no cancer history.
While adolescent and young adult cancer survivors had similar rates of
being uninsured as those without cancer (21 percent versus 23 percent),
survivors were 67 percent more likely to forgo routine medical care due
to costs in the previous year. Cost barriers were particularly high for
younger survivors aged 20 to 29 years (44 percent versus 16 percent of
controls) and female survivors (35 percent versus 18 percent of
controls). Survivors reporting poorer health also experienced more cost
barriers.
“The Affordable Care Act is an important step to ensuring that
adolescent and young adult cancer survivors have health insurance
coverage and improving their health care access; however, they need to
be educated about the importance of regular health care to monitor for
late effects,” said Dr. Kirchhoff. “Furthermore, even the insured
survivors in our study reported unmet health care needs due to cost
barriers, suggesting that adolescent and young adult cancer survivors
need resource supports beyond health insurance.”
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