The rising costs of cancer care and subsequent medical financial hardship for cancer survivors and families are well documented in the United States. Less attention has been paid to employment disruptions and loss of household income after a cancer diagnosis and during treatment, potentially resulting in lasting financial hardship, particularly for working-age adults not yet age-eligible for Medicare coverage and their families. In this article, the authors use a composite patient case to illustrate the adverse consequences of cancer diagnosis and treatment for employment, health insurance coverage, household income, and other aspects of financial hardship. They summarize existing research and provide nationally representative estimates of multiple aspects of financial hardship and health insurance coverage, benefit design, and employee benefits, such as paid sick leave, among working-age adults with a history of cancer and compare them with estimates among working-age adults without a history of cancer from the most recently available years of the National Health Interview Survey (2019–2021). Then, the authors identify opportunities for addressing employment and health insurance coverage challenges at multiple levels, including federal, state, and local policies; employers; cancer care delivery organizations; and nonprofit organizations. These efforts, when informed by research to identify best practices, can potentially help mitigate the financial hardship associated with cancer.

中文翻译：

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工作年龄成年人的癌症诊断和治疗：对美国就业、健康保险覆盖和经济困难的影响


在美国，癌症治疗费用的不断上升以及癌症幸存者和家庭随后面临的医疗经济困难是有据可查的。人们很少关注癌症诊断后和治疗期间的就业中断和家庭收入损失，这可能会导致持久的经济困难，特别是对于尚未达到医疗保险覆盖年龄的工作年龄成年人及其家人。在本文中，作者使用一个复合患者案例来说明癌症诊断和治疗对就业、健康保险覆盖范围、家庭收入和经济困难其他方面的不利影响。他们总结了现有的研究，并对有癌症病史的工作年龄成年人的经济困难和健康保险覆盖范围、福利设计和员工福利（例如带薪病假）的多个方面提供了具有全国代表性的估计，并将其与在职成年人的估计进行了比较。 - 最近几年的国家健康访谈调查（2019-2021 年）中没有癌症病史的年龄成年人。然后，作者确定了在多个层面解决就业和健康保险覆盖挑战的机会，包括联邦、州和地方政策；雇主；癌症护理提供组织；和非营利组织。这些努力如果通过研究确定最佳实践，可能有助于减轻与癌症相关的经济困难。