Adverse Financial Impact of Breast Cancer for Black vs White Women

Key Points

  • Black women were more likely to have any adverse financial impact attributable to cancer.
  • Black women were more likely to have income loss, financial barriers to care, transportation barriers to care, job loss, and loss of health insurance.

In a study reported in the Journal of Clinical Oncology, Wheeler et al found that black women experience significantly worse financial impact from breast cancer compared with white women, which may contribute to barriers to treatment compliance and worse outcomes.

Study Details

The population-based prospective cohort study (Carolina Breast Cancer Study) involved 2,494 black (49%) and white (51%) women aged < 50 years with incident breast cancer in North Carolina from 2008 to 2013. Participants provided medical records and data on demographics, socioeconomic status, and financial impact of cancer at 5 and 25 months after diagnosis.

Financial Impact

After diagnosis, in unadjusted analysis, 58% of black women vs 40% of white women reported any adverse financial impact of cancer, 49% vs 35% reported decreased income, 24% vs 11% reported financial barriers to care, 14% vs 3% reported transportation barriers to care, 14% vs 6% reported loss of job as result of cancer, and 5% vs 1% reported loss of health insurance (all P < .001).

In analysis adjusted for age, stage at diagnosis, and treatment received, black women were more likely (all P < .001) to report adverse financial impact attributable to cancer (adjusted risk difference [aRD] = +14%), income loss (aRD = +10%), financial barriers to care (aRD = +10%), transportation barriers to care (aRD = +10%), job loss (aRD = 6%), and loss of health insurance (aRD = +3%). In analysis including socioeconomic factors, the effect of race was attenuated, but differences for job loss, transportation barriers, income loss, and overall financial impact remained significant.

The investigators concluded, “Compared with white women, black women with breast cancer experience a significantly worse financial impact. Disproportionate financial strain may contribute to higher stress, lower treatment compliance, and worse outcomes by race. Policies that help to limit the effect of cancer-related financial strain are needed.”

The study was supported by grants from the American Cancer Society, University Cancer Research Fund of North Carolina, National Cancer Institute, and Susan G. Komen Foundation.

Stephanie B. Wheeler, MPH, PhD, of the University of North Carolina at Chapel Hill, is the corresponding author for the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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