"The financial consequences of cancer care for patients and their families are substantial," said senior and corresponding author Dr. Benjamin Breyer, chief of urology at University of California, San Francisco's (UCSF) partner hospital Zuckerberg San Francisco General Hospital and Trauma Center.
"It has been shown previously that patients with cancer, particularly those who are underinsured or lack insurance entirely, may sell possessions or go into debt or bankruptcy to pay for costs associated with care," Breyer said in a university news release.
"We wanted to gauge how crowdfunding is being used to support oncology care needs, including the financial effect of insurance," he explained.
The researchers analyzed more than 1,000 fundraising campaigns for U.S. cancer patients listed on GoFundMe.com on Oct. 7, 2018. The patients had the 20 most common cancers, including breast cancer, leukemia, lung, brain, colon and pancreatic cancer.
Nearly 32% had the most advanced cancer stage (stage 4), about 42% had received chemotherapy, and nearly 31% had undergone surgery, the study authors said.
The median fundraising goal was $10,000 while the median donation level was $2,125. About one-third of the postings were done by a third-party, and children accounted for about 15%.
Cancer patients hoped to raise money for medical bills (41%), medical travel (25%) and non-medical expenses (23%), such as child care, lost wages and funerals, according to the report. Fewer than 5% of patients sought donations for alternative treatments.
Underinsured patients -- who made up about 26% of those in the study - were more likely to seek funds for unpaid medical bills and requested $10,000 more, on average, but did not receive higher donations than other patients, the findings showed.
The study was published online Aug. 9 in JAMA Internal Medicine.
Technology advances, expensive cutting-edge therapies and improved access to treatment have contributed to the rising cost of cancer care in the United States, the researchers noted.
Study first author Dr. Andrew Cohen explained, "While the Affordable Care Act reduced the rate of uninsured people, cost containment measures have not been achieved." Cohen is a former clinical instructor in the UCSF department of urology and is now an assistant professor at the Brady Urological Institute at Johns Hopkins Medicine, in Baltimore.
"People face multiple competing financial needs due to illness. For example, medical travel costs were a major problem for some people. It's possible that the regionalization of oncologic care is improving cancer outcomes, but simultaneously it increases the financial burden on patients," Cohen said.
"Our results suggest that the financial burden of health care requires more attention and advocacy. Furthermore, the posting of medical information by patients and third parties on crowdfunding sites raises serious ethical, privacy and fraud concerns," he concluded.
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