Factors correlated with financial hardship among cancer patients during the COVID-19 pandemic

Sep 22, 2026

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Purpose: Financial hardship from cancer care is linked to poor patient outcomes, and COVID-19–related economic disruption may have intensified financial concerns. Methods: Adults on active treatment for stage 0–IV breast or lung cancer who completed a 5-point Likert screening for financial difficulty (11/2020–11/2021) were analyzed using generalized estimating equations. Results: Among 2245 patients, 7% reported significant financial hardship, and higher zip-code level SDI quartiles and factors including younger age and treatment variables showed associations. Conclusion: Greater SDI and clinical/treatment factors may inform targeted screening for vulnerable populations.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Purpose

Methods

Results

Conclusion

OPEN ACCESS Citation: Myers SP, Tsung C, Chen JC, Gokun Y, Plascak J, Elsaid MI, et al. (2026) Factors correlated with financial hardship among cancer patients during the COVID-19 pandemic. PLoS One 21(3): e0342984. [https://doi](https://doi). org/10.1371/journal.pone.0342984 Editor: Usama Waqar, Emory University, UNITED STATES OF AMERICA Received: July 2, 2025 Accepted: February 1, 2026 Published: March 9, 2026 Copyright: © 2026 Myers et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement: Data cannot be shared publicly because it contains HIPAA information such as full addresses. De-identified data are available from the Ohio State University Enterprise for Research Innovation and Knowledge (contact erik@osu. edu) . RESEARCH ARTICLE Factors correlated with financial hardship among cancer patients during the COVID-19 pandemic Sara P. Myers1,2*, Carolyn Tsung3, J. C. Chen1, Yevgeniya Gokun4, Jesse Plascak5, Mohamed I. Elsaid4,6,7, Ashley Rosko8, Carolyn J. Presley7,8, Electra D. Paskett5, Ann Scheck McAlearney2,9, Samilia Obeng-Gyasi1 1 Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, Ohio, United States of America, 2 CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America, 3 Washington University in St. Louis, St Louis, Missouri, United States of America, 4 Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America, 5 Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America, 6 Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America, 7 Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America, 8 Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America, 9 Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America * [sara.myers@osumc.edu](sara.myers@osumc.edu) Abstract Purpose Financial hardship from cancer care is associated with poor patient outcomes. Economic disruption during the COVID-19 pandemic may have exacerbated patients’financial concerns. We explore how social deprivation index (SDI), clinical, and treatment-related factors impacted financial hardship in this observational secondary analysis using data collected prospectively during implementation of financial hardship screening from our NCI-designated center during COVID-19 . Methods Adults aged ≥18 years undergoing active treatment for stage 0-IV breast or lung cancer and who completed a 5-point Likert response-item screening for financial difficulty between 11/2020 and 11/2021 were included. Generalized estimating equations assessed associations between quartiles of zip-code level SDI, a composite obtained using data from US Census and American Community Survey, and binary outcome of financial hardship adjusting for relevant covariates. PLOS One | [https://doi.org/10.1371/journal.pone.0342984](https://doi.org/10.1371/journal.pone.0342984) March 9, 2026 1 / 12 Funding: Samilia Obeng-Gyasi is funded by Conquer Cancer Breast Cancer Research Foundation Advanced Clinical Research Award for Diversity and Inclusion in Breast Cancer Research, The Society of University Surgeons,

FAQs

What factors are associated with financial hardship among cancer patients during COVID-19?

Higher zip-code level social deprivation index (SDI) quartiles are associated with financial hardship, along with younger age, Black race, comorbidities, and receipt of radiation and/or chemotherapy.

Who was included in the study and how was financial hardship measured?

Adults (≥18) undergoing active treatment for stage 0–IV breast or lung cancer who completed a 5-point Likert item screening for financial difficulty between 11/2020 and 11/2021 were included.

How many participants reported significant financial hardship and what proportion had it?

Significant financial hardship (Likert responses ≥2) was reported by 7% of the 2245 patients.

Sep 22, 2026

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