Cancer survivors forgoing care because of cost… perhaps

Young adult cancer survivors often forgo follow up medical care, reads the headline of this article on amednews.com (via the AMA’s Twitter feed). The article goes on to cite a study in which

Researchers analyzed data from the Centers for Disease Control and Prevention’s 2009 Behavioral Risk Factor Surveillance System on adults 20 to 39. A total of 979 had been diagnosed with cancer between ages 15 and 34 and were at least five years past the date of their diagnosis. They were compared with 67,216 adults with no cancer.

Both groups had similar rates of having health insurance. But those with a history of cancer were 67% more likely to go without care because of cost.

The rest of the article goes on to talk about insurance rates, unemployment, cancer costs, and the economic hardship of the young.  I’ve scanned the research and it seems that they used self-reports from the subjects to determine why they were forgoing care.

That leads me to ask: is it likely that cost is the only reason for the 67% difference in care-seeking?  Perhaps the dominant paradigm that heath care is too expensive provides a convenient answer without digging into more complex and uncomfortable reasons.  Purely speculating, I’d wonder about emotional exhaustion of Damocles Syndrome, a feeling of invulnerability from both the level of mental maturity and having survived cancer already, resentment at time lost to illness and a desire to just move on until a symptom appears,  an avoidance of potential bad news, for the sake of themselves and loved ones, or any of countless personal or cultural reasons.

Maybe I’m completely wrong on this, but it seems like the researchers put a lot of thought into economic factors and few into human ones.  It’s not that the study is inaccurate — it reports what the subjects told them — but that the conclusions seem superficial.

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