Not many things are scarier than a cancer diagnosis — within minutes of finding out they have cancer, many patients begin to worry about things such as surgery, chemotherapy and death. But cancer patients should worry about their bank accounts, too: New research shows that the disease can take a heavy toll on patients’ pocketbooks, even long after they recover.
A new study published in Cancer, the peer-reviewed journal of the American Cancer Society, helps quantify cancer’s true financial cost. To get a sense of how cancer affects things such as individual earnings, family income, employment and work hours, sociologist Anna Zajacova and colleagues from the University of Wyoming ditched traditional means of studying the disease’s financial toll. “Prior estimates were all over the place,” Zajacova says. That’s because previous studies relied on small, incomplete or subjective estimates that focused more on the diagnoses themselves than patients’ financial realities.
To get a better sense of the real numbers behind cancer and income, Zajacova turned to the Panel Study of Income Dynamics. The study, which has followed a representative sample of U.S. families since the 1960s, is a gold mine for economists looking for long-term financial data. And because its questionnaires cover things such as how family members spend their time and whether they have been diagnosed with cancer, the PSID gave Zajacova and her colleagues a chance to look at people’s economic lives before and after they became cancer patients. Ultimately, the study looked at financial data for a group of 1,117 cancer patients and 15,856 non-patients between 1990 and 2009.
It’s not a rosy picture.
In fact, cancer’s financial toll began even before people became patients, with incomes falling in the year before a diagnosis was confirmed. Within five years of diagnosis, cancer patients’ probability of being employed fell by nearly 10 percentage points, and within two years of diagnosis, the number of hours worked dropped by an average of 40 percent. The average working-age cancer survivor lost about 200 hours, or five weeks, of full-time work within a year of diagnosis.
Women’s economic losses were statistically insignificant — perhaps because of their already less lucrative workforce participation or, Zajacova speculates, employment in more flexible professions. But men paid a higher price for their diagnoses: They lost an average of 300 hours of full-time employment a year and their average labor-market earnings slipped by 60 percent three and five years after diagnosis.
Zajacova is comforted by at least one of her study’s findings about the resilience of families. Although families’ overall incomes drop 20 percent on average within two years of a member’s diagnosis, they recover by year five. These numbers could show families rallying by moving in together, shifting their workloads or pooling their money, Zajacova says. On a family level, she notes, “the impacts eventually become statistically insignificant.”
The fact that cancer diagnoses affect finances may not be surprising, Zajacova says, but that doesn’t mean it’s not important to have better statistics. “If anything, people would anticipate that there would be a large economic shock,” she says. “What our findings do is confirm this belief or assumption and specify how large of an effect this has, especially for men.” And financial challenges often make physical ones even worse: In a 2010 survey of oncology social workers, 63 percent reported that patients who were struggling financially were less compliant with treatment plans.
For the most part, cancer survivors’ incomes never bounce back to pre-diagnosis levels. But that could change with a better understanding of how different factors — and different cancers — affect patients' finances. Zajacova hopes her findings can contribute to a more nuanced understanding of the delicate interplay between money and illness. “This is a systemic issue of the U.S. labor market,” she says. “It’s a lot more unforgiving to people getting sick than just about any labor market in any other developed country.” Perhaps better data could someday help cancer patients thrive financially and physically, no matter where they live.
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