Parental Cancer Linked to Financial Hardships in Children

Children of parents with a cancer history may experience delays in medical care because of a lack of transportation, according to a new study.

A cancer diagnosis may have long-term psychosocial consequences for both patients and their families. In children, it may cause regressive behavior, anxiety, and difficulties in school and other social settings.

Increasing evidence has also shed light on the financial burden linked to cancer diagnosis and treatment, called financial toxicity. It is defined by the psychological stress of financing care, the direct costs of medical care and the harmful compensatory measures taken to mitigate health care costs, such as deferred or delayed medications. In the United States, about one-half of people with cancer experience financial toxicity.

Researchers at the American Cancer Society (ACS) investigated how parents' cancer affects minor children's economic needs. Their study, published in JAMA Network, used the National Health Interview Survey from 2013 to 2018 to identify children aged five to 17 years old with and without a parental cancer history.

The results showed parental cancer history was associated with more severe family-level food insecurity, such as worrying about food running out or inability to afford balanced meals. Additionally, parental cancer history was linked to worry by parents about paying monthly bills, housing-related costs, and delays in child medical care because of lack of transportation.

Girls, non-Hispanic Black children, those whose parents had multiple comorbidities, and children living in low-income families were found to be especially vulnerable to unmet economic needs.

The authors say the findings are concerning because they suggest that minor children bear a portion of the health consequences that result from their parents' diagnosis. And this may have generational effects.

Some of the study's limitations include the self-reported nature and minimal detail regarding cancer diagnosis, timing, and treatment. Moreover, the study does not draw a causal association between parental cancer diagnosis and the child's economic needs.

In the U.S., cancer is one of the most expensive medical conditions, as patients may require multiple treatments, including surgery, chemotherapy, and targeted therapy. Cancer patients and their families also face substantial nonmedical costs, such as transportation to treatment centers.

A small 2022 study found that nearly three-quarters of insured people with advanced colorectal cancer faced financial hardships within 12 months of beginning treatment. One in four reported financial problems in the first 3 months after their diagnosis.

Zhiyuan "Jason" Zheng, senior principal scientist of health services research at the ACS and lead author of the study, says: "Strategies are needed to identify children with parental cancer history and to identify and address these critical unmet needs. Also, further study is needed to determine if these unmet economic and social needs among children last through adulthood."