In the Journals

Childhood cancer survivors likely to need federal income assistance as adults

Long-term survivors of childhood cancers are more likely to claim supplemental social security income or social security disability insurance as adults than those without a cancer history, according to study findings.

Although the 5-year survival rate from a diagnosis of childhood cancer is 80%, a significant number of those survivors face future health-related challenges as adults, including second malignancies, heart failure and other medical complications, according to study background. These treatment-related complications and a resulting inability to work may lead to financial difficulties, the researchers wrote.

“The long-term impact of cancer can affect other issues besides health outcomes,” Anne C. Kirchhoff, PhD, MPH, assistant professor in the department of pediatrics in the division of pediatric hematology/oncology at the Huntsman Cancer Institute at the University of Utah, said in a press release. “We need to do a better job of helping people function throughout their lives, not just when they are finishing their cancer therapy.”

Kirchhoff and colleagues compared data from 698 survivors of childhood cancer from the NCI’s Childhood Cancer Survivor Study who were first diagnosed between 1970 and 1986 with data from 210 siblings in a healthy control group. The researchers evaluated current or former enrollment in two federal disability programs: Supplemental Security Income (SSI) — intended for individuals with limited income who have no prior work history — and Social Security Disability Insurance (SSDI), which pays disability benefits to adults who have a work history and have paid social security taxes.

Overall, survivors of childhood cancer were five times more likely to have been enrolled in a federal Social Security assistance program.

The researchers found that 13.5% of survivors of childhood cancer had ever enrolled in SSI compared with 2.6% of the control group, and 10% of the survivors had enrolled in the SSDI compared with 5.4% of the control group.

Survivors who had received cranial radiation doses of 25 Gy or greater were more likely to report current enrollment in SSI (RR = 3.93; 95% CI, 2.05-7.56) and SSDI (RR = 3.65; 95% CI, 1.65-8.06).

The development of severe or life-threatening conditions among survivors also was associated with a greater likelihood of enrolling in SSI (RR = 3.77; 95% CI, 2.04-6.96) and SSDI (RR = 2.73; 95% CI, 1.45-5.14) compared with survivors with mild, moderate or no health conditions.

The likelihood of SSI enrollment also was greater among females (RR = 1.74; 95% CI, 1-3.06) and those who were diagnosed when aged 4 years or younger (RR = 7.56; 95% CI, 1.02-56.16).

The researchers said the limitations of their study included a small comparator cohort. With only 18 family pairs in the cohorts, the investigators were unable to account for genetic or other childhood factors that may have influenced SSI or SSDI enrollment.

Further, the researchers did not adjust for marital status or income.

Still, the maximum SSI benefit in 2015 is $733 per month — or $8,796 annually — which is below the federal poverty level for a single adult, Kirchhoff and colleagues wrote.

“Our study is an important contribution to a growing national research base on the needs of childhood cancer survivors,” Kirchhoff told HemOnc Today. “By identifying survivors who may need insurance and financial assistance, researchers and clinicians can better link patients and their families to resource supports to help them throughout their lives.” – by Anthony SanFilippo

Anne C. Kirchhoff, PhD, MPH, can be reached at the University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT 84132; email: anne.kirchhoff@hci.utah.edu

Disclosure: The researchers report no relevant financial disclosures.

Long-term survivors of childhood cancers are more likely to claim supplemental social security income or social security disability insurance as adults than those without a cancer history, according to study findings.

Although the 5-year survival rate from a diagnosis of childhood cancer is 80%, a significant number of those survivors face future health-related challenges as adults, including second malignancies, heart failure and other medical complications, according to study background. These treatment-related complications and a resulting inability to work may lead to financial difficulties, the researchers wrote.

“The long-term impact of cancer can affect other issues besides health outcomes,” Anne C. Kirchhoff, PhD, MPH, assistant professor in the department of pediatrics in the division of pediatric hematology/oncology at the Huntsman Cancer Institute at the University of Utah, said in a press release. “We need to do a better job of helping people function throughout their lives, not just when they are finishing their cancer therapy.”

Kirchhoff and colleagues compared data from 698 survivors of childhood cancer from the NCI’s Childhood Cancer Survivor Study who were first diagnosed between 1970 and 1986 with data from 210 siblings in a healthy control group. The researchers evaluated current or former enrollment in two federal disability programs: Supplemental Security Income (SSI) — intended for individuals with limited income who have no prior work history — and Social Security Disability Insurance (SSDI), which pays disability benefits to adults who have a work history and have paid social security taxes.

Overall, survivors of childhood cancer were five times more likely to have been enrolled in a federal Social Security assistance program.

The researchers found that 13.5% of survivors of childhood cancer had ever enrolled in SSI compared with 2.6% of the control group, and 10% of the survivors had enrolled in the SSDI compared with 5.4% of the control group.

Survivors who had received cranial radiation doses of 25 Gy or greater were more likely to report current enrollment in SSI (RR = 3.93; 95% CI, 2.05-7.56) and SSDI (RR = 3.65; 95% CI, 1.65-8.06).

The development of severe or life-threatening conditions among survivors also was associated with a greater likelihood of enrolling in SSI (RR = 3.77; 95% CI, 2.04-6.96) and SSDI (RR = 2.73; 95% CI, 1.45-5.14) compared with survivors with mild, moderate or no health conditions.

The likelihood of SSI enrollment also was greater among females (RR = 1.74; 95% CI, 1-3.06) and those who were diagnosed when aged 4 years or younger (RR = 7.56; 95% CI, 1.02-56.16).

The researchers said the limitations of their study included a small comparator cohort. With only 18 family pairs in the cohorts, the investigators were unable to account for genetic or other childhood factors that may have influenced SSI or SSDI enrollment.

Further, the researchers did not adjust for marital status or income.

Still, the maximum SSI benefit in 2015 is $733 per month — or $8,796 annually — which is below the federal poverty level for a single adult, Kirchhoff and colleagues wrote.

“Our study is an important contribution to a growing national research base on the needs of childhood cancer survivors,” Kirchhoff told HemOnc Today. “By identifying survivors who may need insurance and financial assistance, researchers and clinicians can better link patients and their families to resource supports to help them throughout their lives.” – by Anthony SanFilippo

Anne C. Kirchhoff, PhD, MPH, can be reached at the University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT 84132; email: anne.kirchhoff@hci.utah.edu

Disclosure: The researchers report no relevant financial disclosures.