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Financial toxicity impact on younger versus older adults with cancer in the setting of care delivery.

  • Author(s): Corrigan, Kelsey L;
  • Fu, Shuangshuang;
  • Chen, Ying-Shiuan;
  • Kaiser, Kelsey;
  • Roth, Michael;
  • Peterson, Susan K;
  • Shih, Ya-Chen T;
  • Jagsi, Reshma;
  • Giordano, Sharon H;
  • Volk, Robert J;
  • Yabroff, K Robin;
  • Banegas, Mathew P;
  • Acquati, Chiara;
  • Conti, Rena M;
  • Ma, Hilary Y;
  • Ku, Kimberly;
  • You, Y Nancy;
  • Smith, Grace L
  • et al.

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Young adults and other working-age adults with cancer are at risk for cancer-related financial toxicity (FT), including material hardships, depletion of coping resources, and psychological burden. This study compares FT domains in young adults (18-39 years old) (YAs), other working-age adults (40-64 years old), and older adults (≥65 years old) receiving cancer care.


A total of 311 adults were surveyed using the multi-domain Economic Strain and Resilience in Cancer instrument measuring FT (0-10 score indicating least to greatest FT; score ≥5 severe FT). Participants were receiving ambulatory care from March-September 2019. Associations of age with overall FT and material hardship, coping resource depletion, and psychological burden FT domains were tested using Kruskal-Wallis and χ2 tests and multivariable generalized linear models with gamma distribution.


YAs (median age, 31.5 years) comprised 9.6% of the sample; other working-age adults comprised 56.9%. Overall, material, coping, and psychological FT scores were worse in younger age adults versus older adults (P < .001 in all multivariable models). Compared with older adults, younger age adults demonstrated worse material hardship (median scores, 3.70 vs 4.80 vs 1.30 for YAs, other working-age, and older adults, respectively; P < .001), coping resource depletion (4.50 vs 3.40 vs 0.80; P < .001), and psychological burden (6.50 vs 7.00 vs 1.00; P < .001). Fifty percent of YAs had severe overall FT versus 40.7% of other working-age adults and 9.6% of older adults (P < .001).


Younger age adults with cancer bore disproportionate FT. Interventions to address unmet needs are critical components for addressing FT in this population.

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