Adult survivors of childhood cancer should be screened for financial problems that might cause them to delay or skip medical care or to suffer psychological distress. The recommendation from St. Jude Children’s Research Hospital (St. Jude) researchers followed an analysis that found 65 percent of survivors reported financial challenges related to their childhood cancer diagnoses.

The findings follow the largest study yet focused on financial hardship and its consequences for childhood cancer survivors. The research appeared in the Journal of the National Cancer Institute.

The analysis found that financial hardship, both material and psychological, related to healthcare expenses is widespread among pediatric cancer survivors. The consequences affect all aspects of survivors’ lives. Financial hardship is associated with reduced health-related quality of life, leaving survivors at greater risk for depression and suicidal thoughts, poor retirement planning, and difficulty securing health and life insurance. Previous studies have reported that suicidal thoughts are associated with increased mortality rates.

“These findings suggest primary-care doctors and oncologists should routinely screen childhood cancer survivors for possible financial hardship,” said Chan Huang, PhD, first author of the study and an associate faculty member in the St. Jude Department of Epidemiology and Cancer Control. St. Jude is developing a screening tool to help identify at-risk survivors as well as possible interventions to address the problem.

For now, Huang recommended healthcare providers routinely ask patients who are childhood cancer survivors if they are unable to purchase medications, ever skip appointments for economic reasons, or worry about how to pay their medical bills.

This study focused on survivors’ self-reported financial resources as well as their level of financial distress and coping strategies. About one in five survivors reported that childhood cancer had affected their financial status. More than half of survivors indicated they worried about paying for care, and 33 percent said finances kept them from seeking medical care.

Overall, 65 percent of survivors identified problems in at least one of the three aspects of financial health that were the study’s focus. Fifty-six percent reported two problem areas, and 9 percent reported experiencing all three.

Chronic health conditions, particularly heart attacks and reproductive disorders, and second cancers as part of treatment-related late effects were associated with an increased risk of financial hardships, including worrying about paying for care. Intensive cancer treatment was also associated with a greater risk of financial hardship.

“Severe late effects that emerge early in life and disrupt education and training opportunities are a double hit for survivors. These health problems decrease the survivors’ earning mobility and financial security later in life,” Huang said. “The phenomenon leaves them at risk for poor health and psychological outcomes compared to healthier survivors.”

This article was adapted from information provided by St. Jude.