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A cancer diagnosis can cause out-of-pocket costs to surge, study finds

Last updated: August 5, 2025 9:41 pm
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A cancer diagnosis can cause out-of-pocket costs to surge, study finds
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A cancer diagnosis increases privately insured patients’ monthly out-of-pocket costs, which also rise as the disease progresses, new research shows.

Out-of-pocket costs jumped by $592.53 per month for the six months after a diagnosis, according to a recent report published in JAMA Open Network.

The study underscores the financial toll a cancer diagnosis can take on individuals, even for those who are insured but don’t yet qualify for Medicare. While cancer tends to strike later in life, when most patients in treatment are receiving Medicare benefits, a cancer diagnosis can pose an undue financial burden on younger people with private insurance, the report found.

Those out-of-pocket costs highlight the need for policy reform, the report said.

The research “underscores the need for policies such as paid sick leave that address both insurance continuity and financial assistance, especially for patients with more advanced cancer,” the report states.

Out-of-pocket costs increased based on a patient’s cancer progression, the analysis found.

Patients with stage 0 cancer saw their costs rise by $462 per month compared to non-cancer patients, while stage 4 cancer cost people with private insurance an additional $719.97 per month in out of pocket costs. Costs rise as the disease progresses because patients typically require more treatment during cancer’s later stages, leading to greater medical expenditures.

“This result seems straightforward; later-stage disease is associated with more intensive workup and treatment that can drive higher medical expenditures,” the report states.

Researchers analyzed medical claims records from the Surveillance, Epidemiology, and End Results (SEER) cancer registry to compare the out-of-pocket costs of privately insured individuals under the age of 65 who were diagnosed with breast, colorectal, and lung cancer, to those without cancer.

New research from the American Cancer Society shows that as more people aged 45-49 undergo screening for colon cancer, more early stage diagnoses are being made.

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