Part of ASCO Conference Coverage
The findings emphasize how financial difficulties create barriers to cancer screening, delay diagnosis, and force difficult choices between basic needs and healthcare. However, experts say there is hope in the form of resources and policy changes.
Medical Debt and Cancer Incidence Rates
Researchers analyzed data from all 3,143 counties in the United States and found a striking connection between medical debt and cancer rates. Counties with higher percentages of residents carrying medical debt in collections showed significantly higher rates of both overall cancer diagnoses and late-stage cancer cases.
Medical debt puts consumers
in a state of fear or apprehension
to seek medical care from a preventive space.
This results in skipped screenings,
preventable cancers being missed,
and diseases progressing faster without notice.
explained Noor Ali, MBBS, MPH, a Florida-based healthcare financial advisor.
For every 1% increase in the population with medical debt in collections, researchers found a 75-case increase in overall cancer incidence per 100,000 people. Late-stage diagnoses also increased significantly for multiple cancer types, including lung and bronchus, colorectal, and melanoma.
Housing Insecurity and Forgone Care in Cancer Survivors
A separate 2025 ASCO Annual Meeting presentation of nearly 1,800 cancer survivors revealed that 13% reported housing problems, while 19% had to delay or skip medical care due to costs. Experts say the overlap between these issues creates a devastating cycle.
Cancer care specifically requires ambulatory continuity,
and most treatment plans,
including radiation, chemotherapy, immunotherapy,
and even some surgery,
are primarily delivered in an ambulatory care center,
said Regina Jacob, MD, MSCE, Medical Director of Cancer Survivorship at Northwell Health Cancer Institute in Lake Success, New York.
Dr. Jacob explained that healthcare becomes secondary when you can’t afford stable housing.
When rent or temporary housing eats up most of your income,
healthcare becomes a luxury, not a necessity.
People prioritize keeping a roof overhead,
even if it means delaying or skipping
doctor’s visits, medications, or treatments.
The Demographics of Financial Healthcare Barriers
According to the data, women are more likely to skip care when facing financial pressure than men. Researchers found that 8% of female survivors reported housing insecurity compared to 4% of male survivors. Women were also more likely to forgo care – 22% versus 16% for men.
Those aged 45 to 64 showed higher rates of skipping care compared to other age groups. Dr. Jacobs explained that the findings could make sense when considering the financial pressures this demographic faces.
Middle-aged individuals
may already have 1-2 chronic conditions,
and a third chronic condition,
especially if it is cancer,
may result in more financial strain,
given the rising costs
of managing those conditions.
Many times,
middle-aged patients are caregiving
for both the younger generation of children
and the older generation of their parents,
simultaneously contributing
to additional financial strain.
The Ripple Effects of Financial Fear
The impact goes beyond just skipping appointments. Financial stress creates a cascade of problems that can compromise every aspect of your care:
-
Transportation barriers: Without stable housing or reliable income, getting to regular appointments becomes a significant challenge, especially if you live in an area with limited public transportation.
-
Medication storage:
For patients who obtain medications
or medical equipment,
safe storage becomes a challenge
for those with housing insecurity,
further jeopardizing their health,
Dr. Jacob explained.
-
Emergency-only care: People facing housing insecurity often rely on emergency departments for interim care. Since cancer treatment is primarily delivered in outpatient settings, this approach doesn’t work well for comprehensive cancer care.
-
Mental health impact:
The constant stress of housing insecurity
severely impacts both physical and mental health,
increasing the need for care
while simultaneously making it harder to access,
said Dr. Jacob.
Resources That Can Help
While the research reveals significant challenges, resources are available to help bridge the gap between financial hardship and quality cancer care.
Insurance Navigation
Some people don’t realize that most health plans cover preventive screenings at no cost.
All ACA-compliant health insurance policies
cover all preventive and screening services for free.
Either consumers might not be aware
or even have the health insurance policies
that cover those screening services.
Dr. Ali emphasized.
Financial Assistance Programs
Most major cancer centers offer financial aid programs to help cover medical costs, including co-pays and prescription medications. Ask your healthcare team about available options. They can connect you with a financial counselor or social worker who can guide you through the process and help determine which programs you may be eligible for.
It is also worth looking into government benefits for people with cancer, such as Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
Transportation
Many communities offer non-emergency transportation services specifically for medical appointments. Your care team can help connect you with local resources. Additionally, you can search your state’s Department of Health or Human Services website for transportation options. Some health insurance, including some Medicare and Medicaid plans, may also cover transportation services for medical appointments.
Housing Support
Organizations like the American Cancer Society provide temporary housing assistance and can help navigate housing stability programs. Additionally, many patient advocate groups offer mortgage, rent, and utility assistance to qualified individuals. To find available housing support, speak with a social worker at your treatment facility or search for terms like “housing assistance for (your condition).”
Emotional Support
Most hospitals have psychological services for patients and families. Support groups also provide a safe space to ask questions and share your experience. Additionally, online forums and resources like CancerCare offer free counseling and support services over the phone or through video conferencing.
Legal Assistance
Many organizations offer free legal assistance to people with cancer. These services may be helpful if you need help navigating the complex legal system, advice on employment and disability rights, or assistance with estate planning.
Policy Changes on the Horizon
Dr. Jacob explained that future policies addressing housing, transportation, nutrition, behavioral health, and exercise costs will allow survivors to focus on treatment and recovery. Research findings are influencing policy discussions about how to better support people with cancer facing financial hardship.
Proposed changes include expanded coverage for supportive services, improved transportation assistance, and stronger safety nets for housing stability.
Future policies need to target these high-risk groups,
researchers noted, particularly focusing on women, near-poor individuals, and middle-aged adults who are most likely to forgo care when forced to choose between basic needs and healthcare.
Taking Action Despite Financial Stress
If you are facing cancer while dealing with financial challenges, help is available. Start by speaking with your healthcare team about your financial constraints. Treatment facilities often know about resources that aren’t widely advertised.
Early detection and treatment remain the best way to improve outcomes. Don’t skip screenings or delay treatment because you are worried about the bill. Instead, call the facility where you wish to be treated to discuss financial resources. You can also contact non-profit organizations for financial assistance for medical expenses. Several organizations offer grants or other forms of financial support to help pay for medical expenses and other treatment-related costs.
You can also seek advice from a financial counselor or advocate specializing in helping cancer finances. They can provide valuable guidance on budgeting, debt management, and negotiating with medical providers for lower costs.
Patient Power LLC
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