COVID-19 testing and financial toxicity in cancer survivors

To investigate the financial strain placed upon cancer survivors during the COVID-19 pandemic.

We investigated the association of COVID-19 testing with financial toxicity among individuals with a history of cancer from using cross-sectional data from the 2020 National Health Interview Survey. Multivariable logistic regression (MLR) analysis assessed associations between clinical and sociodemographic covariates with being unable to pay medical bills currently and having problems paying medical bills over the last 12 months.

Of the 4,130 individuals assessed, 420 (10.2%) reported difficulty paying bills currently and 758 (18.4%) reported difficulty paying bills over the last 12 months. Respondents who reported being currently unable and/or having problems paying medical bills over the last 12 months were, on average, younger than those who did not. MLR analysis demonstrated that older age and annual income > $35,000 were associated with lower odds of being unable to pay medical bills currently, while ever being tested for COVID-19 increased likelihood. Older age and annual income over $100,000 were associated with decreased odds of having difficulty paying medical bills over the last 12 months, whereas ever being tested for COVID-19 was associated with increased odds.

Cancer patients who report having difficulty paying medical bills were more likely to have been tested for COVID-19, indicating an association between COVID-19 testing and increased financial toxicity among cancer survivors.

Healthcare providers should be aware of the financial strain placed upon patients with cancer during the pandemic so sufficient support may be provided.