Some survivors of childhood and young adult cancer struggle with medical costs decades after their cancer diagnosis

Published: 10/17/2017

Medical Bill

Despite tremendous advances in the treatment and cure of children with cancer, many adult survivors experience health problems that need ongoing medical care. LTFU Study researchers recently completed a study that looked at survivors’ experience of financial stress due to the cost of medical care.  They conducted a survey of a group of LTFU Study participants that included 580 survivors and 173 siblings. 

The research team found that one in 10 survivors in the study spent 10 percent, or more, of their annual income on out of pocket medical costs, compared to just three percent of the siblings. The researchers defined out of pocket costs as payments for prescription drugs, copayments and insurance deductibles. They did not include the cost of insurance premiums in their definition.

Survivors who spent a high percentage of income on medical costs were more likely to:

  • be unemployed,
  • have lower incomes,
  • have more severe chronic conditions, or
  • be hospitalized in the past year.

These survivors were more than eight times as likely as siblings to report having problems paying medical bills. They were also more likely to worry about seeing health care providers as needed, to think about filing for bankruptcy, and to try to control costs by:

  • putting off medical appointments,
  • skipping a test, treatment, or follow-up, or
  • taking a smaller dose of their medications to extend the time between refills.

The researchers stated that these individuals may be at risk of jeopardizing their health because of the need to limit or forego medical care because of financial concerns.

What does this mean for you? 

This study is a first step in understanding the impact of the financial burden of medical costs for adult survivors of childhood cancer. Dr. Ryan Nipp, an oncologist at Massachusetts General Hospital in Boston, who led the study, says, “It is important to appreciate that the survivors in the study were, on average, more than 30 years from their cancer diagnosis and yet many still struggle with high out of pocket medical costs and the resulting financial burden.”

The researchers urged health systems and providers to make it a priority to develop programs that include financial services, social work services, and patient navigators for survivors who are experiencing hardship because of high medical costs.


Nipp RD, Kirchhoff AC, Fair D, et al. Financial Burden in Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study. J Clin Oncol 2017 35 (Oct. 17): 3474-3481.