Significant Financial Burden Associated With Thyroid Cancer Treatment, Survivorship

In thyroid cancer with and without prior exposure to VEGF therapy, the response rates and survival f
In thyroid cancer with and without prior exposure to VEGF therapy, the response rates and survival f
An analysis of studies in the literature sought to determine the financial burden patients with thyroid cancer incur from diagnosis, treatment, and surveillance.

Here’s a sobering cancer fact that might surprise some: according to multiple observational studies, thyroid cancer is accompanied by the greatest degree of financial burden. Thyroid cancer survivors tend to have the highest bankruptcy rates across all studied cancer types.

A group of researchers sought to analyze the cost and financial burdens of thyroid cancer on patients in the United States and set guidance for future research that could relieve some of that burden. Their review was published in JAMA Otolaryngology-Head & Neck Surgery.

The researchers reviewed numerous studies that delved into the costs of thyroid cancer diagnosis, treatment, and surveillance. They highlighted independent risk factors that are associated with a higher financial burden: lack of health insurance, younger age, and an annual household income less than $49,000.

The research suggests that financial burden of thyroid cancer has a significant impact on patients’ mental health, as well as their employment and household finances. Researchers with the Thyroid Cancer Survivors’ Cohort Study found that 23.7% of the cohort reported using most or all of their savings to pay for out-of-pocket costs associated with their thyroid cancer, with 15.1% borrowing funds and 15.9% reporting they had been contacted by a collections agency. This study also found that patients experienced worse anxiety, depression, and social functioning as a result of the financial burden.

The research team noted limitations to the currently available research on the issue — and on each data source.  Some sources are surveys that are only offered intermittently; others are limited by small cohort size. And even if the data was highly reliable, “they would represent an incomplete proxy of the true financial burden borne by patients, which must take into account the ways in which patients finance these costs,” the researchers reported.

The researchers suggested future research focus on obtaining longitudinal disease-specific evidence and integrating underutilized sources of data, such as public records and credit reports. “Further research is needed to examine how the accumulation of debt over time affects employment, insurance coverage, health outcomes, and bankruptcy,” they concluded.

Making recommendations that help patients will be easier if providers have a more complete understanding of the financial burden posed by thyroid cancer and its treatment. This could help create targeted interventions and drive policy change.

Reference

Uppal N, Cunningham C, James B. The cost and financial burden of thyroid cancer on patients in the US: a review and directions for future research. JAMA Otolaryngol Head  Neck Surg. Published online May 05, 2022. doi:10.1001/jamaoto.2022.0660