Researchers at the University of Alabama at Birmingham observed many older adults with cancer were experiencing financial distress at diagnosis, and screening for it may identify potential noncompliance among patients, allowing for early intervention. These results were published in JCO Oncology Practice.

For this study, 447 patients older than 60 years were recruited for a prospective registry study during their initial consultation with an oncologist between 2017 and 2019. All participants responded to a patient-reported geriatric assessment (GA) which included a single question about whether or not their medical costs were beyond their means.

Patients were aged median 69 (interquartile range [IQR], 64 to 75) years, 59.5% were men, 75.2% were White, 51.5% had Medicare, and 71.8% had advanced stage cancer.

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More than a quarter (27.1%) of patients expressed they were experiencing financial distress. Those patients were significantly younger (P =.007), more likely to be non-White (P <.001), to be unemployed or disabled (P <.001), less likely to have graduated high school (P <.001), and to be uninsured (P =.039).

Financial distress was associated with GA-identified falls during the past 6 months (odds ratio [OR], 2.39; 95% CI, 1.37-4.17; P =.002), taking at least 9 daily medications (OR, 2; 95% CI, 1.18-3.40; P =.034), reduced global physical health (b, -2.82; P =.014), and reduced mental health (b, -3.31; P =.002).

This study may have been limited by its broad definition of financial distress.

These data indicated a single-question self-assessment may allow for better stratification of patients who are in need of financial assistance to avoid treatment noncompliance.


Giri S, Clark D, Al-Obaidi M, et al. Financial distress among older adults with cancer. JCO Oncol Pract. Published online October 30, 2020. doi:10.1200/OP.20.00601