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Assessing disparities in healthcare access among cancer survivors living in the United States
Article first published online: 14 JUN 2010
Published 2010 by the American Cancer Society
Volume 116, Issue 14, pages 3493–3504, 15 July 2010
How to Cite
Weaver, K. E., Rowland, J. H., Bellizzi, K. M. and Aziz, N. M. (2010), Forgoing medical care because of cost. Cancer, 116: 3493–3504. doi: 10.1002/cncr.25209
Results from this article were presented at the American Association for Cancer Research 2009 Cancer Health Disparities Conference, Carefree, Arizona, February 3-6, 2009.
This article is US Government work and, as such, is in the public domain in the United States of America.
- Issue published online: 2 JUL 2010
- Article first published online: 14 JUN 2010
- Manuscript Accepted: 10 NOV 2009
- Manuscript Revised: 22 OCT 2009
- Manuscript Received: 3 AUG 2009
- healthcare disparities;
- long-term survivors;
- health services accessibility
Many US cancer survivors live years after diagnosis, which emphasizes the importance of healthcare access for survivors. It is not known whether having cancer has an impact on disparities in healthcare access that are present in the general population. The objective of this study was to examine the prevalence of forgoing care because of financial concerns in a representative sample of US adults to determine whether cancer history and race/ethnicity are associated with the likelihood of forgoing medical care.
Data from the US National Health Interview Survey (NHIS) from 2003 to 2006 were used to identify 6602 adult cancer survivors and 104,364 individuals who had no history of cancer. Self-reports of forgoing medical care services because of cost were analyzed according to cancer history and race/ethnicity using multivariate logistic regression.
The prevalence of forgoing care because of cost among cancer survivors was 7.8% for medical care, 9.9% for prescription medications, 11.3% for dental care, and 2.7% for mental healthcare. Cancer survivors aged <65 years were more likely to delay or forgo all types of medical care compared with adults who did not have a history of cancer. Hispanic and black cancer survivors were more likely to forgo prescription medications and dental care than white survivors. Disparities among cancer survivors largely were reflective of those in the general adult population.
More than 2 million US cancer survivors did not get 1 or more needed medical services because of financial concerns during the studied period. Future research needs to examine the impact of forgoing care on survivors' quality of life and survival. Cancer 2010. Published 2010 by the American Cancer Society.