Aims: Cancer-related financial toxicity adversely affects physical and psychological wellbeing and influences healthcare decision-making, leading to poorer health outcomes. This paper explores contemporary experiences of Australian adolescents and young adults (AYA) impacted by their own or a family member’s cancer.
Methods: A cross-sectional survey was completed by 141 AYAs aged 16-25 years (mean age 20 years) impacted by their own or a family member’s cancer diagnosis. Measures assessed financial impacts (direct/indirect costs), financial distress (subjective financial-related stress) and financial toxicity (the cumulative economic and psychosocial burden), financial support utilisation and unmet support needs.
Results: Financial impacts were substantial, with more than one-quarter reporting direct out-of-pocket treatment costs exceeding AUD$2,000, in addition to travel and meal expenses. Indirect impacts included delayed or paused education (50%), missed study time (53%), reduced work hours (32%), and job loss (32% of AYAs with cancer). These impacts contributed to reported income reductions attributable to cancer for 31% of AYAs with cancer, 44% affected by family cancer, and 63% of bereaved young people. Financial distress affected 57% of participants, while concerns about family financial stability were reported by 35% of AYAs with cancer and 57% affected by family cancer. Financial toxicity was reported by 57% of AYAs with cancer, 55% affected by family cancer, and 68% of bereaved young people. Strategies to cope with financial challenges included drawing on savings (42%) and seeking money from family and friends (23%). Key unmet needs included assistance accessing financial support, managing education and employment-related costs, and achieving personal life goals.
Conclusions: Cancer-related financial burdens impact Australian AYA’s health, employment, education and wellbeing during treatment and well beyond treatment. Financial assistance programs with financial navigation, and educational and vocational support could play a crucial role in improving cancer care and outcomes in Australia.