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Inequality in income change among cancer survivors five years after diagnosis: Evidence from a French national survey

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  • Caroline Alleaume
  • Marc-Karim Bendiane
  • Patrick Peretti-Watel
  • Anne-Déborah Bouhnik

Abstract

Worldwide, around 18 million people receive a cancer diagnosis each year, most of whom survive long enough to face additional cancer-related costs. In France, most costs directly related to cancer are covered by the National Health Insurance Fund, and cancer patients can receive treatments without paying advance fees. In this context, the costs faced by cancer survivors are mostly social costs. Drawing on fundamental cause theory, this study aimed to explore the socially-differentiated evolution of cancer survivor’s income five years after diagnosis. Our study draws on the findings of VICAN5, a French national survey that was conducted in 2015/2016 in a representative sample of 4,174 cancer survivors to obtain information on living conditions five years after diagnosis, and that was restricted to 12 tumour sites accounting for 88% of global cancer incidence in France. We used the multiple imputation method and the Heckman selection model to identify the factors associated with a decrease in household income per consumption unit (HICU), while accounting for missing data. Among survivors still working five years after diagnosis, 17.6% reported lower income at survey than at diagnosis. After adjustment for socio-demographic and medical characteristics, the decrease in HICU was more frequent in women, singles, low educated survivors, and survivors with reduced working time. Finally, subjective measures of income variation and economic well-being were a useful complement to objective measures since 31.6% of cancer survivors still working five years after diagnosis reported a perceived decrease in household income. In conclusion, inequalities in economic well-being persist long after diagnosis in France, and this despite the fact that most cancer-related costs are covered by the French National Health Insurance Fund. Consequently, more attention should be paid to cancer patients with low socio-economic status to help reduce inequalities in post-diagnosis living conditions.

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  • Caroline Alleaume & Marc-Karim Bendiane & Patrick Peretti-Watel & Anne-Déborah Bouhnik, 2019. "Inequality in income change among cancer survivors five years after diagnosis: Evidence from a French national survey," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-18, October.
  • Handle: RePEc:plo:pone00:0222832
    DOI: 10.1371/journal.pone.0222832
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    References listed on IDEAS

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    1. Aileen Timmons & Rachael Gooberman-Hill & Linda Sharp, 2013. ""It's at a Time in Your Life When You Are Most Vulnerable": A Qualitative Exploration of the Financial Impact of a Cancer Diagnosis and Implications for Financial Protection in Health," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
    2. Sung‐Hee Jeon, 2017. "The Long‐Term Effects of Cancer on Employment and Earnings," Health Economics, John Wiley & Sons, Ltd., vol. 26(5), pages 671-684, May.
    3. Steffen Torp & Jonn Syse & Alain Paraponaris & Sævar Gudbergsson, 2017. "Erratum to: Return to work among self-employed cancer survivors," Post-Print hal-03586274, HAL.
    4. Paraponaris, Alain & Teyssier, Luis Sagaon & Ventelou, Bruno, 2010. "Job tenure and self-reported workplace discrimination for cancer survivors 2 years after diagnosis: Does employment legislation matter?," Health Policy, Elsevier, vol. 98(2-3), pages 144-155, December.
    5. Steffen Torp & Jonn Syse & Alain Paraponaris & Sævar Gudbergsson, 2017. "Return to work among self-employed cancer survivors," Post-Print hal-03586254, HAL.
    6. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 31(3), pages 129-137.
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    1. Siebinga, Ties M. & Janssen, Silvie H. M. & Boumans, Anke W. & Van Eenbergen, Mies C. & Siflinger, Bettina & Van der Graaf, Winette T. A. & Husson, Olga, 2023. "Financial outcomes of adolescent and young adult cancer survivors : A longitudinal population-based registry study," Other publications TiSEM 475feaa3-b6f8-4e1d-9e4e-8, Tilburg University, School of Economics and Management.

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