Rural-urban differences in financial burden among cancer survivors: an analysis of a nationally representative survey

Details

• Alternative Title:
  Support Care Cancer
• Personal Author:
  Zahnd, Whitney E. ; Davis, Melinda M. ; Rotter, Jason S. ; Vanderpool, Robin C. ; Perry, Cynthia K. ; Shannon, Jackilen ; Ko, Linda K. ; Wheeler, Stephanie B. ; Odahowski, Cassie L. ; Farris, Paige E. ; Eberth, Jan M.
• Description:
  Purpose
  
  Rural cancer survivors may disproportionately experience financial problems due to their cancer because of greater travel costs, higher uninsured/underinsured rates, and other factors compared to their urban counterparts. Our objective was to examine rural-urban differences in reported financial problems due to cancer using a nationally representative survey.
  
  Methods
  
  We used data from three iterations of the National Cancer Institute’s Health Information and National Trends Survey (2012, 2014, and 2017) to identify participants who had a previous or current cancer diagnosis. Our outcome of interest was self-reported financial problems associated with cancer diagnosis and treatment. Rural-urban status was defined using 2003 Rural-Urban Continuum Codes. We calculated weighted percentages and Wald chi-square statistics to assess rural-urban differences in demographic and cancer characteristics. In multivariable logistic regression models, we examined the association between rural-urban status and other factors and financial problems, reporting the corresponding adjusted predicted probabilities.
  
  Findings
  
  Our sample included 1359 cancer survivors. Rural cancer survivors were more likely to be married, retired, and live in the Midwest or South. Over half (50.5%) of rural cancer survivors reported financial problems due to cancer compared to 38.8% of urban survivors (p = 0.02). This difference was attenuated in multivariable models, 49.3 and 38.7% in rural and urban survivors, respectively (p = 0.06).
  
  Conclusions
  
  A higher proportion of rural survivors reported financial problems associated with their cancer diagnosis and treatment compared to urban survivors. Future research should aim to elucidate these disparities and interventions should be tested to address the cancer-related financial problems experienced by rural survivors.
  
  
• Subjects:
  Adolescent Adult Aged Cancer Survivors Female Humans Logistic Models Male Middle Aged Neoplasms Rural Population Self Report Urban Population Young Adult

  More +
• Source:
  Support Care Cancer. 27(12):4779-4786
• Pubmed ID:
  30972645
• Pubmed Central ID:
  PMC6786922
• Document Type:
  Journal Article
• Funding:
  U48 DP005006/DP/NCCDPHP CDC HHS/United States ; U48 DP005017/DP/NCCDPHP CDC HHS/United States ; U48 DP005013/DP/NCCDPHP CDC HHS/United States ; U48 DP005000/DP/NCCDPHP CDC HHS/United States ; N/A/CC/CDC HHS/United States ; U48 DP001932/DP/NCCDPHP CDC HHS/United States ; K07 CA211971/CA/NCI NIH HHS/United States ; U48 DP005014/DP/NCCDPHP CDC HHS/United States ; N/A/CA/NCI NIH HHS/United States ; UL1 TR002319/TR/NCATS NIH HHS/United States
• Place as Subject:
  United States
• Volume:
  27
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:07ae4302066145224b9f3dbe3b8302c802d1b3018647617bfdc75372ec4f89a0
• Download URL:
  https://stacks.cdc.gov/view/cdc/83028/cdc_83028_DS1.pdf
• File Type:
  [PDF - 153.87 KB ]