ArticlePreventive medicine2019
Financial hardship among rural cancer survivors: An analysis of the Medical Expenditure Panel Survey.
Article in Preventive medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Describing financial toxicity among cancer patients in different income countries: a systematic review and meta-analysis.Frontiers in public health · 2023Pooled it
- Residents' preference trade-offs for critical illness insurance scheme design: a discrete choice experiment in Shandong Province, China.Health policy and planning · 2026Article
- Disparities in Rural-Urban Cancer Care Outcomes among Pediatric, Adolescent, and Young Adult Populations: A Comprehensive Narrative Review.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Review
- Household income and county income inequality are associated with financial hardship among cancer survivors in New Jersey.Journal of cancer survivorship : research and practice · 2026Article
- Differences in patient-centered burdens and economic outcomes based on sociodemographic characteristics and social determinants of health: a scoping review.Frontiers in public health · 2026Article
- Material financial hardship and insurance-related experiences among Utah's rural and urban cancer survivors.Journal of cancer survivorship : research and practice · 2025Article
- Non-monetary burdens of out-of-pocket costs incurred by patients and caregivers for medical care: a scoping review.BMJ open · 2025Article
- Navigating the completing cancer treatment incentive in Malaysia: patient insights and implementation challenges.BMC health services research · 2025Article
- Sun protection behavior beliefs among adults living in rural United States: A qualitative study in Minnesota.PloS one · 2025Article
- Healthcare professionals' perspectives of barriers to cancer care delivery for American Indian, rural, and frontier populations.PEC innovation · 2024Article
- Impact of a Comprehensive Financial Navigation Intervention to Reduce Cancer-Related Financial Toxicity.Journal of the National Comprehensive Cancer Network : JNCCN · 2024Article
- Medical financial hardship between young adult cancer survivors and matched individuals without cancer in the United States.JNCI cancer spectrum · 2024Article
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- Trends in Healthcare Expenditures among Adults in the United States by Cancer Diagnosis Status, 2008-2016: A Cross-Sectional Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
- Cost-Related Medication Nonadherence and Patient Cost Responsibility for Rural and Urban Cancer Survivors.JCO oncology practice · 2022Article
- Urban-rural differences in financial toxicity and its effect on cancer survivors' health-related quality of life and emotional status: a latent class analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
- Core functions of a financial navigation intervention: An in-depth assessment of the Lessening the Impact of Financial Toxicity (LIFT) intervention to inform adaptation and scale-up in diverse oncology care settings.Frontiers in health services · 2022Article
- Cancer history, insurance coverage, and cost-related medication nonadherence in Medicare beneficiaries, 2013-2018.Journal of managed care & specialty pharmacy · 2021Article
- Unmet Care Needs and Financial Hardship in Patients With Metastatic Non-Small-Cell Lung Cancer on Immunotherapy or Chemoimmunotherapy in Clinical Practice.JCO oncology practice · 2021Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
Some cancer survivors report spending 20% of their annual income on medical care. Undue financial burden that patients face related to the cost of care is referred to as financial hardship, which may be more prevalent among rural cancer survivors. This study examined contrasts in financial hardship among 1419 rural and urban cancer survivors using the 2011 Medical Expenditure Panel Survey supplement - The Effects of Cancer and Its Treatment on Finances. We combined four questions, creating a measure of material financial hardship, and examined one question on financial worry. We conducted multivariable logistic regression analyses, which produced odds ratios (OR) for factors associated with financial hardship and worry, and then generated average adjusted predicted probabilities. We focused on rural and urban differences classified by metropolitan statistical area (MSA) designation, controlling for age, education, race, marital status, health insurance, family income, and time since last cancer treatment. More rural cancer survivors reported financial hardship than urban survivors (23.9% versus 17.1%). However, our adjusted models revealed no significant impact of survivors' MSA designation on financial hardship or worry. Average adjusted predicted probabilities of financial hardship were 18.6% for urban survivors (Confidence Interval [CI]: 11.9%-27.5%) and 24.2% for rural survivors (CI: 15.0%-36.2%). For financial worry, average adjusted predicted probabilities were 19.9% for urban survivors (CI: 12.0%-31.0%) and 18.8% for rural survivors (CI: 12.1%-28.0%). Improving patient-provider communication through decision aids and/or patient navigators may be helpful to reduce financial hardship and worry regardless of rural-urban status.
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Registered trials
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