Americans under 65 who are diagnosed with cancer face steep out-of-pocket expenses, nearly $600 more per month than their peers without cancer, and those expenses have risen sharply as the disease phases get. one JAMA Network Open Studies that tracked more than 46,000 individuals show that patients with stage 4 cancer pay more than $700 a month in the first six months after diagnosis, revealing financial gaps even among those with insurance.
Higher cancer stage, higher patient costs
The researchers linked private insurance claims to the SEER program’s cancer registry data to track actual patient spending. They found that out-of-pocket expenses (OOPC) (including deductibles, copayments and co-insurance) were significantly caused after the diagnosis of breast, colorectal or lung cancer.
On average, cancer patients pay $592.53 more per month than similar people without cancer. But for those with advanced cancer, the financial blow is even worse:
- Stage 0: $462 per month
- Phase 2: $661/month increase
- Stage 4: $720 per month
The authors use a differential approach to control baseline spending trends, making it one of the earliest studies on the direct financial burden of cancer treatment in isolated private insurance populations.
Start financial stress before treatment begins
Costs start to increase in diagnosis months, regardless of cancer type, and keep rising for six months. For some patients, these costs total over $4,000 during the initial treatment period. Importantly, the study excluded patients over the age of 65 who usually have Medicare, focusing on young people navigating employer-sponsored insurance.
Why the stage is important, why hasn’t been measured until now
Although it seems obvious that treatment costs for later stage cancer are more expensive, this study is the first to quantify this connection using high-quality staging data related to actual insurance claims.
“To the best of our knowledge, this result has not been proven empirically before,” the author wrote.
This is partly because private insurance datasets rarely include clinical cancer stages. By combining claims with SEER registry data, the study overcomes obstacles and provides new insights into how disease progression affects patient finances.
Policy Impact beyond the numbers
The authors warn that high OOPC can trigger “financial toxicity,” a term for economic stress that can cause patients to delay or give up care. Since most Americans under 65 rely on employer-based insurance, cancer diagnosis can threaten health and work safety.
For policy makers and employers, the findings point to some urgent needs:
- Expand paid sick leave to retain insurance during treatment
- Provide early screening to capture cancer before
- Designing insurance plans minimizes upfront expense burden for serious illnesses
As cancer rates increase in young people, the issues understood and addressed are no longer medical insurance-only issues.
Magazine: JAMA Network Open
doi: 10.1001/jamanetworkopen.2025.21575
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