Cancer patients face increased risk of bankruptcy

Patients diagnosed with cancer are much more likely to declare bankruptcy than those without the disease, according to a new study in Health Affairs (May 15, 2013).

Cancer patients are at least 2.5 times more likely to declare bankruptcy than those without cancer, noted the study authors, from the Fred Hutchinson Cancer Research Center. They also found that younger cancer patients had two to five times higher bankruptcy rates compared with older patients, and overall bankruptcy filings increased following diagnosis.

The researchers analyzed data from a population-wide registry of people older than age 21 who lived in western Washington and were diagnosed with cancer between January 1995 and December 2009. They were compared with a randomly sampled age-, sex-, and ZIP code-matched population of people without cancer.

Cancer cases were identified using the Cancer Surveillance System of Western Washington, a population-based cancer registry based at Fred Hutchinson that is part of the National Cancer Institute's Surveillance Epidemiology and End Results Program. The cancer and control cohorts were both linked with the records of the U.S. Bankruptcy Court for the Western District of Washington. Researchers included Chapter 7 or Chapter 13 bankruptcy filings only.

Among the study's key findings:

  • Between 1995 and 2009, there were 197,840 people in western Washington who were diagnosed with cancer and met the inclusion criteria for the study. Of those, 4,408 (2.2%) filed for bankruptcy protection after diagnosis. Of the matched controls who were not diagnosed with cancer, 2,291 (1.1%) filed for bankruptcy.

  • Compared with cancer patients who did not file for bankruptcy, those who did were more likely to be younger, female, and nonwhite.

  • The proportion of cancer patients who filed for bankruptcy within one year of diagnosis was 52%, compared with 16% within one year for the control group. For bankruptcy filings within five years of diagnosis, the proportion of cancer patients was about 1.7%, compared with 0.7% for the control group.

  • The incidence rates for bankruptcy at one year after diagnosis, per 1,000 person-years, for the cancers with the highest overall incidence rates were as follows: thyroid, 9.3; lung, 9.1; uterine, 6.8; leukemia/lymphoma, 6.2; colorectal, 5.9; melanoma, 5.7; breast, 5.7; and prostate, 3.7.

  • The incidence rate for all cancers combined was 6.1. The high bankruptcy incidence rate for those with thyroid cancer may be because thyroid cancer affects younger women more often than other cancers do according to the researchers.

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