Association of Major Adverse Financial Events and Later-Stage Cancer Diagnosis in the United States

作者：Joan L. Warren, Angela B. Mariotto, Jennifer L. Stevens, Amy J. Davidoff, Veena Shankaran, Kevin C. Ward, Xiao‐Cheng Wu, Stephen M. Schwartz, Lynne Penberthy, K. Robin Yabroff · 发表于：Journal of Clinical Oncology · 年份：2024 · DOI：10.1200/jco.23.01067 · 被引用次数：6 · 研究领域：Economic and Financial Impacts of Cancer、Healthcare Policy and Management、Cancer survivorship and care

PURPOSE This study assessed the prevalence of specific major adverse financial events (AFEs)—bankruptcies, liens, and evictions—before a cancer diagnosis and their association with later-stage cancer at diagnosis. METHODS Patients age 20-69 years diagnosed with cancer during 2014-2015 were identified from the Seattle, Louisiana, and Georgia SEER population–based cancer registries. Registry data were linked with LexisNexis consumer data to identify patients with a history of court-documented AFEs before cancer diagnosis. The association of AFEs and later-stage cancer diagnoses (stages III/IV) was assessed using separate sex-specific multivariable logistic regression. RESULTS Among 101,649 patients with cancer linked to LexisNexis data, 36,791 (36.2%) had a major AFE reported before diagnosis. The mean and median timing of the AFE closest to diagnosis were 93 and 77 months, respectively. AFEs were most common among non-Hispanic Black, unmarried, and low-income patients. Individuals with previous AFEs were more likely to be diagnosed with later-stage cancer than individuals with no AFE (males—odds ratio [OR], 1.09 [95% CI, 1.03 to 1.14]; P < .001; females—OR, 1.18 [95% CI, 1.13 to 1.24]; P < .0001) after adjusting for age, race, marital status, income, registry, and cancer type. Associations between AFEs prediagnosis and later-stage disease did not vary by AFE timing. CONCLUSION One third of newly diagnosed patients with cancer had a major AFE before their diagnosis. Patie...