Background: In connection with technical progress, the cost of cancer care is increasing and the patient's economic burden becomes heavier.
Aim: The actual situation of the economic burden and the change of the feeling of burden are clarified, and measures for the reduction of the burden are examined.
Methods: The patient survey was conducted in 42 hospitals in Japan.
Results: The reply was obtained from 3,277 cancer patients (response rate:47.3%). The average age was 61.7 years old. The annual out-of-pocket expense was $8,740 on average, and the payout of private insurance and the refund were $5,350. The substantial burden was $3,390. It is assumed that 30.6% of respondents felt economic burden very heavy and 42.2% felt slightly heavy. The percentage of patients whose treatment was influenced by the economic situation was 5.5%. The ratio of patients who quitted their work was 24.7%. In gastric cancer, the feeling of economic burden went up on the occasion of examinations and went down by the payout of private insurance. It went up again on surgical treatment and got stuck at high levels. In colorectal cancer, it went up by surgical treatment and chemotherapy but it followed a downswing subsequently. In lung cancer, the feeling of burden went up at its maximum by the molecule-targeted therapy, and remained high after that. In case of breast cancer, the feeling of burden showed full of ups and downs. 34.5% of patients replied that the explanation about the economic burden of the treatment was sufficient, while 42.6% replied that there was no explanation at all.
Conclusions: It is important to explain the economic burden to patients timely and adequately in response to the changes of the feeling of burden, in order to reduce the number of patients who might give up the treatment by the economic reasons.