(ChemotherapyAdvisor) – Helping at-risk patients early during chemotherapy for stage 3 colon cancer “may prevent long-term financial adverse effects,” results of a study published in Journal of Clinical Oncology online March 12 has found. Despite having health-insurance coverage, 38% of patients undergoing adjuvant chemotherapy for stage 3 colon cancer were found to experience financial hardship, according to the exploratory analysis.

Of 555 patients identified from a population-based cancer registry representing 13 counties in the state of Washington, 284 (51.2%) completed a comprehensive survey on treatment-related costs. Nearly all of the respondents were insured during treatment for stage 3 colon cancer.

“Patients were considered to have experienced financial hardship if they accrued debt, sold or refinanced their home, borrowed money from friends or family, or experienced a 20% or greater decline in their annual income as a result of treatment-related expenses,” the investigators wrote.

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Younger age and lower annual household income were found to be the factors most closely associated with treatment-related financial hardship, and those most closely associated with treatment nonadherence were younger age, lower income, and unemployment or disability, which occurred in most instances following diagnosis.

Mean patient age was 51.3 years. “Compared with older, retirement-age individuals, younger patients may have more difficulty making financial adjustments in the face of cancer treatment costs because of higher baseline household expenses related to mortgage payments or child-rearing and fewer years over which to accumulate assets,” they wrote. “Patients in lower income categories may be similarly vulnerable because of an inability to accumulate a buffer of assets and savings.”

They found a significant proportion of reported insurance-coverage denials were related to the chemotherapy itself; specifically, capecitabine. Such denials and the subsequent insurance appeals process can be stressful and may result in treatment delays, affecting clinical outcomes. Patients were also denied coverage for supportive medications, which can have a negative effect on the ability to tolerate treatment and quality of life.

“Future research should focus on exploring the impact of various financial experiences on quality of life and identifying specific factors that contribute to financial hardship. Interventions should be developed to help at-risk individuals before they face financial ruin,” the authors concluded.