Evidence map›Paper›PMID 35316473›Full record

ArticleJournal of cancer survivorship : research and practice2024

Forgoing physician visits due to cost: regional clustering among cancer survivors by age, sex, and race/ethnicity.

Christina Gu, Patricia I Jewett, K Robin Yabroff, Rachel I Vogel, Helen M Parsons, Ronald E Gangnon, Himal Purani, Anne H Blaes

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cancer survivorship : research and practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Christina GuDivision of Hematology and Oncology, Department of Medicine, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA. guxxx294@umn.edu.ORCID 0000-0002-5692-3168
Patricia I JewettDivision of Hematology and Oncology, Department of Medicine, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
K Robin YabroffSurveillance & Health Equity Science Department, American Cancer Society, Atlanta, GA, USA.
Rachel I VogelDivision of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, USA.
Helen M ParsonsDivision of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.
Ronald E GangnonDepartment of Population Health Sciences, University of Wisconsin, Madison, WI, USA.
Himal PuraniDivision of Hematology and Oncology, Department of Medicine, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
Anne H BlaesDivision of Hematology and Oncology, Department of Medicine, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
University of Minnesota · USAmerican Cancer Society · USUniversity of Wisconsin–Madison · US

Funding

Women's CancerP30CA077598 · NCI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI Jeffrey S. Miller · 1998 to 2026
$100.4M
NCI NIH HHS P30 CA077598
6 · The paper itself

Abstract

backgroundInnovative treatments have improved cancer survival but also increased financial hardship for patients. While demographic factors associated with financial hardship among cancer survivors are known in the USA, the role of geography is less clear.

methodsWe evaluated prevalence of forgoing care due to cost within 12 months by US Census region (Northeast, North Central/Midwest [NCMW], South, West) by demographic factors (age, sex, race/ethnicity) among 217,981 cancer survivors aged 18 to 82 years from the 2015-2019 Behavioral Risk Factor Surveillance System survey. We summarized region- and group-specific prevalence of forgoing physician visits due to cost and used multilevel logistic regression models to compare regions.

resultsThe prevalence of forgoing physician visits due to cost was highest in the South (aged < 65 years: 19-38%; aged ≥ 65: 4-21%; adjusted odds ratios [OR], NCMW versus South, OR: 0.63 [0.56-0.71]; Northeast versus South, OR: 0.63 [0.55-0.73]; West versus South, OR: 0.73 [0.64-0.84]). Across the USA, including regions with broad Medicaid expansion, younger, female, and persons of color most often reported cost-related forgoing physician visits.

conclusionForgoing physician visits due to cost among cancer survivors is regionally clustered, raising concerns for concentrated poor long-term cancer outcomes. Underlying factors likely include variation in regional population compositions and contextual factors, such as Medicaid expansion and social policies. Disproportionate cost burden among survivors of color in all regions highlight systemic barriers, underscoring the need to improve access to the entire spectrum of care for cancer survivors, and especially for those most vulnerable.

Indexed as

Cancer SurvivorsNeoplasmsAdolescentAdultAgedAged, 80 and overCluster AnalysisEthnicityFemaleHumansMedicaidMiddle AgedSurvivorsUnited StatesYoung AdultCancer survivorshipEthnic disparityFinancial burdenFinancial toxicityRacial disparityRegional disparity

Identifiers

PMID35316473
PMCPMC9492897
OpenAlexW4220903343

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.