Financial Effects of Cancer Diagnosis

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The financial impact
of a cancer diagnosis
Linda Sharp
Aileen Timmons

National
Cancer
Registry
Ireland

Kindly supported by

The financial impact
of a cancer diagnosis
Linda Sharp
Aileen Timmons

With the support of:
Harry Comber, Director, National Cancer Registry (NCR)
Noeleen Donnelly, Human Resources Manager, Irish Cancer Society (ICS) Joan Kelly, Nursing Services Manager, ICS
Mairéad Lyons, Head of Services, ICS
John McCormack, Chief Executive, ICS
Niamh Ni Chonghaile, Financial Controller, ICS
Eileen O’Donnell, Oncology Social Worker, St Vincent's Hospital Olwyn Ryan, Patient Support Services Manager, ICS

© National Cancer Registry/Irish Cancer Society 2010

Summary
Introduction
The costs to the health services of the diagnosis and treatment of cancer are substantial. These costs have increased over the past decades and are expected to rise further in coming years with population ageing and advances in treatment. However, the economic burden of cancer does not fall only on the health services, but also on patients, their families, and society as a whole. Until recently, little has been known about the costs incurred by cancer patients and their families.

This project set out to answer the following questions:


What are the main elements of additional cost (medical and non-medical) incurred by cancer patients and their families?



How much additional expense do patients incur as a result of their diagnosis with cancer?



What impact does cancer have on income (e.g. lost pay, availability of sick pay, access to benefits)?



What proportion of patients (a) incur additional costs or (b) experience financial difficulties as a result of their cancer diagnosis?



Are particular groups of patients more vulnerable to incurring additional costs or financial difficulties as a result of having cancer?



What are the consequences of the additional expenses, and any changes in income, for patients and their families?

Methods
The project focussed on breast, prostate and lung cancer. The research was in three stages and used complementary qualitative and quantitative methods. Stage one involved indepth, face-to-face, interviews with key informants, namely 21 hospital-based Oncology Social Workers, based in 11 hospitals. Stage two involved in-depth, face-to-face, interviews with 20 cancer patients who had experienced additional costs, or financial difficulties, as a result of being diagnosed with cancer (11 with breast, five with prostate and four with lung cancer, from eight hospitals). Stage three involved a large postal survey of cancer patients. 1,373 patients diagnosed with breast or prostate cancer in the previous 6-24 months, or with lung cancer in the previous 3-21 months, were identified from the records of the National Cancer Registry and invited to complete the survey; 740 (54%) participated. This triangulation of methods generated rich data and enabled in-depth analysis.

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Key findings
Most patients and families incur additional costs as a result of a cancer diagnosis. These can include direct medical costs such as those associated with seeing consultants, GPs, or allied health professionals, and those associated with buying medications to help alleviate the symptoms of cancer and the side-effects of treatment. In addition, the majority of patients have out-of-pocket expenses in relation to travelling to hospital appointments. Increased utility bills are also common because patients undergoing treatment, or recuperating from surgery, are at home more often than before diagnosis. For some patients and families, the additional costs incurred can be substantial.

The majority of cancer patients who are working need to take time off around diagnosis and during treatment and a substantial proportion do not receive any sick pay from their employer. This means that household income decreases for many patients and their families. In addition, the...
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