Childhood cancer survivors more likely to claim social security support as adults

Children with cancer have a good chance of surviving the disease, as today more than 80% survive because of advances in treatment and care. However, recent studies have shown that some of these more than 420,000 US childhood cancer survivors face future health-related challenges as they become adults such as a second cancer diagnosis, cardiac failure, or other severe medical complications.

These types of major health issues can impact a survivor's ability to work, but it has been unclear if these patients are able to access federal assistance programs. A new study shows for the first time that childhood cancer survivors, with a cancer diagnosis between 1970 and 1986, are more than five times as likely to have been enrolled on a federal social security disability assistance program as compared to persons without a cancer history.

"The long-term impact of cancer can affect other issues besides health outcomes," said Anne Kirchhoff, PhD, a Huntsman Cancer Institute investigator at the University of Utah and the lead author on the study published in the Journal of the National Cancer Institute (2015; doi:10.1093/jnci/djv057). "We need to do a better job of helping people function throughout their lives, not just when they're finishing their cancer therapy."

"Survivors that were younger at diagnosis, age 4 [years] or younger, were about seven times more likely to be on SSI [Supplemental Security Income] than we see with survivors that were diagnosed in their adolescence," said Kirchhoff. In addition, she said SSI enrollment, among survivors, was more likely for females and for those with a history of cranial radiation treatment.

The study looked at health insurance surveys completed in 2011-2012 by a random sample of 698 childhood cancer survivors whose diagnoses were made at birth to age 20 years. Today, they range in age from their 20s to early 60s. The patients are part of a National Cancer Institute initiative, called the Childhood Cancer Survivor Study, which has followed more than 14,000 children and adolescents with cancer since 1994 who survived for at least 5 years after diagnosis. A comparison group of 210 siblings without cancer also responded to the survey and were used as a control for the study.

Kirchhoff said they looked at current or former enrollment on two federal disability programs: SSI for people with limited income who have no prior work history, and Social Security Disability Insurance (SSDI), which pays disability benefits to adults ages 18 years and older who have worked and paid social security taxes.

They found that a total of 13.5% of survivors had ever been enrolled on SSI, while 10% had ever been enrolled on SSDI. This was significantly higher than was found for the comparison group, 2.6% on SSI and 5.4% on SSDI. Survivors were also currently enrolled in SSI more frequently than the US population, 7.3% versus 2.5%, respectively.

Kirchhoff said over the years, research on this survivor population is causing hospitals to rethink how to better care for survivors. "There's really a growing strategy to support survivors in the long term," said Kirchhoff. "For example, here at Huntsman Cancer Institute we have a pediatric cancer late-effects clinic which helps manage issues that might come up with childhood cancer survivors in the long term, including health-management support, health-behavior support, and access to providers to help them with other issues."

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