Presentation (CTI)

OBJECTIVES: Financial toxicity is a noted challenge for younger cancer patients, but less is known about financial toxicity in recently diagnosed older adults. Our objective is to estimate the effect of a recent cancer diagnosis on older adults’ household poverty status.
METHODS: We used longitudinal panel data from Waves 6-14 of the Health and Retirement Survey. The primary outcome was household poverty status in Wave 14. To assess the effects of a recent cancer diagnosis, we excluded respondents who had a cancer history in Waves 6-13. To allow for variability in household income associated with a cancer diagnosis, we excluded respondents reporting a household income below the federal poverty threshold in Wave 13. A composite variable indicating household poverty in Waves 6-12 was included as a potential confounder. Additional covariates were included based on associations noted in existing literature. Missing data were addressed using multiple imputation. We used the doubly robust estimation (DRE) method with multivariable logistic regression for this study. Analyses were conducted in RStudio.
RESULTS: Our study included 14,845 respondents; most were White (68%), and female (57%). The average age was 65 years, and 338 reported a cancer diagnosis between Waves 13 and 14. The DRE’s average treatment effect showed a 0.07 increase in household poverty status among those with a cancer diagnosis, compared to those with no cancer diagnosis. This indicates household income falling below the federal poverty line in the same period as a cancer diagnosis (95% CI: 0.03, 0.11). Model diagnostics indicated good fit (area under curve = 0.79).
CONCLUSIONS: The results of this study suggest that a cancer diagnosis can affect household poverty, even in a short period. Although short-term financial toxicity has been cited among younger cancer patients, this study provides additional evidence for the impact of a cancer diagnosis on older adults.