OBJECTIVES: Data from the early 2000s suggests that cancer survivors, especially those of younger ages, forego medical care due to financial concerns. Decisions to delay or forego (D/F) medical care in patients with cancer after 2013 have not been assessed despite advances in cancer therapy. The Medical Expenditure Panel Survey (MEPS) released a 2016 updated cancer supplement file including questions of D/F of treatments in patients with cancer. Decisions to D/F treatments by demographics and cancer diagnosis as well as out of pocket (OOP) costs were investigated in this study.

METHODS: Weighted frequencies and chi-square tests for categorical variables were run in SAS to test for significant relationships. Variables included fell into four major categories: demographics (age, gender, income, employment status, insurance status, health status), cancer diagnosis (bladder, breast, cervical, colon, lung, lymphoma, melanoma, prostate, or other), D/F of medical care (treatment, follow up care, mental health care, visit to a specialist, prescription medication, or other), and cost (total OOP and total prescription OOP).

RESULTS: Patients with cancer without employment, insurance, and poor health status are more likely to D/F treatment (p-value = 0.0079, 0.0100, and 0.0110, respectively). There were no significant differences in type of cancer diagnosis and D/F of treatments. Patients with cancer are also more likely to D/F mental health care with increasing out of pocket costs (OOP) (p-value = 0.0408).

CONCLUSIONS: Contrary to previously published results, this study does not suggest that demographics or OOP costs are associated with D/F treatment in cancer survivors. However, this study suggests that patients with cancer without employment, insurance, or with poor health status are more likely to D/F of treatment. It is possible that these findings are different than those previously reported as there are more treatment options, less caustic treatment options, and more supportive care options.