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Published in: Supportive Care in Cancer 9/2017

01-09-2017 | Original Article

Counting the cost of cancer: out-of-pocket payments made by colorectal cancer survivors

Authors: Alan Ó Céilleachair, Paul Hanly, Máiréad Skally, Eamonn O’Leary, Ciaran O’Neill, Patricia Fitzpatrick, Kanika Kapur, Anthony Staines, Linda Sharp

Published in: Supportive Care in Cancer | Issue 9/2017

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Abstract

Purpose

Cancer places a significant cost burden on health services. There is increasing recognition that cancer also imposes a financial and economic burden on patients but this has rarely been quantified outside North America. We investigate out-of-pocket costs (OOPCs) incurred by colorectal (CRC) survivors in Ireland.

Methods

CRC survivors (ICD10 C18-20) diagnosed 6–30 months previously were identified from the National Cancer Registry Ireland and invited to complete a postal questionnaire. Cancer-related OOPC for tests, procedures, drugs, allied medications and household management in approximately the year following diagnosis were calculated. Robust regression was used to identify predictors of OOPC; this was done for all survivors combined and stratified by age (<70 and ≥70 years) and employment status (working and not working) at diagnosis.

Results

Four hundred ninety-seven CRC survivors completed questionnaires (response rate = 39%). Almost all (90%) respondents reported some cancer-related OOPC. The average total OOPC was €1589. Stage III at diagnosis was associated with significantly higher OOPCs than other stages in the all-survivor model, in those not working in the employment model and in those under 70 years in the age-stratified model. In all-survivor model, those under 70 also had higher OOPCs, as did those in employment. Having one or more children was associated with significantly lower OOPCs in those under 70 years.

Conclusions

Almost all CRC survivors incur cancer-related OOPCs; for some, these are not insignificant. Greater attention should be paid to the development of services to help survivors manage the financial and economic burden of cancer.
Footnotes
1
In a small number of cases, where clinicians were unable to give a clear indication to the study team, the survivor’s GP was approached.
 
2
Available from the authors on request
 
3
Health-related OOPCs were adjusted to 2008 Euro terms using the Central Statistics Office’s CPI sub-index for health while all other OOPCs were adjusted using the headline CPI.
 
4
This case was a self-employed survivor who had to take on relief workers during his treatment. This cost him €76,000.
 
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Metadata
Title
Counting the cost of cancer: out-of-pocket payments made by colorectal cancer survivors
Authors
Alan Ó Céilleachair
Paul Hanly
Máiréad Skally
Eamonn O’Leary
Ciaran O’Neill
Patricia Fitzpatrick
Kanika Kapur
Anthony Staines
Linda Sharp
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 9/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3683-y

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