Evidence map›Paper›PMID 42693364›Full record

ArticleJournal of cancer survivorship : research and practice2026

Examination of insurance type and cancer treatments with administrative burdens and financial toxicity in a sample of cancer survivors.

Ada Z Lu, Jean C Yi, Nora B Henrikson, Laura E Panattoni, Diana Lowry, Kendall Harkey, Salene M W Jones

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Article in Journal of cancer survivorship : research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

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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

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4 · The record

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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

7 authors.

Ada Z LuDivision of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA.
Jean C YiClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA.
Nora B HenriksonKaiser Permanente Washington Health Research Institute, Seattle, WA, 98101, USA.
Laura E PanattoniDivision of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA.
Diana LowryDivision of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA.
Kendall HarkeyDivision of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA.
Salene M W JonesDivision of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA. smjones3@fredhutch.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMany cancer survivors experience administrative burdens and poor financial outcomes but associations with insurance and cancer treatments are not well studied. This study aimed to fill that gap.

methodsCancer survivors (n = 459), on average 11 years post-diagnosis and in the United States completed a cross-sectional survey. Dependent variables were five types of insurance-related administrative burdens (prior authorization, denials, surprise bills, stepped care, out-of-network care) and four dimensions of financial toxicity. Independent variables were health insurance type at diagnosis and cancer treatments. Logistic and linear regression models assessed the relationships between independent and dependent variables.

resultsForty-six percent reported at least one insurance-related administrative burden. Participants who received immunotherapy (prior authorizations: 33%; surprise bills: 46%; stepped care: 26%), chemotherapy (denial: 22%; stepped care: 17%), surgery (surprise bills: 33%; out-of-network: 16%) and radiation therapy (denials: 24%) reported significantly higher prevalence of administrative burdens than those who had not received those treatments (p's < 0.05). Insurance type was not associated with administrative burdens (p's > 0.05). Surgery, chemotherapy and immunotherapy were associated with more financial coping than those who did not receive these treatments (p's < 0.025). Compared to employer/school-sponsored insurance, most insurance types were not associated with financial toxicity except self-purchased insurance was associated with more financial depression, anxiety and coping (p's < 0.05).

conclusionsPatient-reported administrative burden may be associated with all types of insurance and survivors may respond with more financial coping. IMPLICATIONS FOR CANCER SURVIVORS: Immunotherapy and chemotherapy may have the highest risk for administrative burdens but surgery and radiation therapies can also confer risk.

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Economic wellbeingFinancial burdenFinancial hardshipFinancial healthSocial needs

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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.