OBJECTIVES: To present nationally representative estimates of the impact of cancer survivorship on medical expenditures and lost productivity among adults in the United States. METHODS: Using the 2008-2010 Medical Expenditure Panel Survey we identified 4,960 cancer survivors and 64,431 individuals without a history of cancer aged ≥18 years. Direct medical costs were measured using annual health care expenditures and examined by source of payment and service type. Indirect morbidity costs were estimated from the lost productivity due to health-related unemployment, missed work days, and lost household productivity. We evaluated the economic burden of cancer survivorship by estimating the excess costs among cancer survivors compared with individuals without a history of cancer using multivariable regression models stratified by age (18-64 and ≥65 years) while controlling for age, gender, education, and comorbidities. RESULTS: In 2008-2010, the annual excess economic burden of cancer survivorship was $7,631 per cancer survivor aged 18-64 years and $5,445 per survivor aged ≥65 years. Excess direct medical expenditures comprised the largest share, with excess annual medical expenditures of $5,570 and $4,683 among cancer survivors aged 18-64 years and ≥65 years, respectively. Ambulatory care accounted for the largest share of medical expenditures in both groups.  The largest source of payment was private health insurance for cancer survivors aged 18-64 years, and Medicare for cancer survivors aged ≥65 years. Cancer survivors aged 18-64 years incurred an excess annual productivity loss of $2,061 per individual while cancer survivors aged ≥65 years reported an excess annual lost productivity of $762 per individual. CONCLUSIONS: The economic burden of cancer survivorship is substantial, resulting in excess health care expenditures and lost productivity costs compared with individuals without a history of cancer. Efforts to reduce the economic burden caused by cancer will be increasingly important given the growing population of cancer survivors.