Neurocognitive impairment and financial hardship in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
prospective_cohort · Level II
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- Record sourced from PubMed, PMID 41619762.
- Also identified by DOI 10.1093/jnci/djaf383 and PMC identifier 12927753.
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Abstract
More than 60% of adult survivors of childhood cancer report medical financial hardship due to the cumulative costs of cancer-directed therapy and related chronic health conditions. Whether neurocognitive impairment as a late effect is associated with increased financial hardship is unknown. In a large national cohort of 3023 adult survivors of childhood cancer, we observed a dose-dependent relationship between neurocognitive impairment and financial hardship outcomes. Individuals with 4 impaired neurocognitive domains had over 3-fold increased odds of debt collection (OR = 3.12, 95% CI = 1.91-5.09) and bankruptcy (OR = 3.77, 95% CI = 2.01-7.07) compared to individuals with no impaired neurocognitive domains. After adjusting for education, employment, and household income, the independent association between neurocognitive impairment and financial hardship outcomes persisted suggesting that other mechanisms may be at play. Neurocognitive impairment is an important risk factor for medical financial hardship in this patient population and should be considered for targeted screening and intervention.