Most working adults with cancer struggle with money

Working adults often face a second major worry when they're living with a life-threatening cancer diagnosis: financial hardship.

Nearly 3 in 5 working-age adults with cancer face at least one financial challenge, including taking unpaid leave or losing a job or health insurance, according to an American Cancer Society study published Tuesday.

These financial problems can make it difficult to pay for costly cancer care, create stress and worry or even delay treatment – all factors that can weigh on an individual's health, experts said. The study also found that working adults often miss out on federal medical leave.

"The high costs of cancer care are well documented," said Robin Yabroff, the American Cancer Society's scientific vice president of health services research. "Less attention is paid to financial hardship."

The study said 57% of people diagnosed with cancer had some financial hardship within the past year, compared with 53% of those without cancer. Cancer patients were nearly twice as likely to have a problem paying a medical bill compared with non-cancer patients. They were more likely than non-cancer patients to delay or skip care due to costs, the study said.

Researchers focused on working-age adults, 18-64, who were not yet eligible for Medicare. They are far more likely to get health insurance through an employer, and these plans often include cost-sharing features such as high deductibles.

Treatment costs for cancer patients and their insurer typically far exceed $100,000.

An even bigger challenge can surface if people can no longer work full-time and are no longer eligible for employer health insurance. The study said health insurance status is one of the "strongest correlates" of financial hardship among cancer patients. Nearly 84% of working-age cancer patients who were uninsured reported some type of financial hardship.

Nearly half of adults with a cancer history could no longer work the same hours after their diagnosis. Many took an extended leave or adjusted their schedules, roles or career trajectory, including converting to part-time.

Cancer patients who worked for employers that didn't allow workplace accommodations such as flexible schedules or remote work were less likely to keep a job during cancer treatment, the study said.

About 40% of working adults with a cancer history didn't get paid sick leave from an employer. That was especially true for cancer survivors under 40 who earned less money, the study said.

For cancer survivors whose work gave them paid time off, the time was often not enough for them to get to appointments and complete administrative tasks – everything from contesting billing errors to undergoing surgery.

The Family and Medical Leave Act grants eligible employees up to 12 weeks of unpaid leave. However, the study said about half of adults with a cancer history were employed by small businesses that didn't have to comply.

American Cancer Society representatives said the findings underscore the importance of family leave for working-age adults with a cancer history.