JCO Oncol Pract. 2025 Nov 6:OP2500389. doi: 10.1200/OP-25-00389. Online ahead of print.
ABSTRACT
PURPOSE: Adolescents and young adults (AYAs, age 15-39 years) with cancer are vulnerable to the harmful effects of cancer-related financial hardship. Our objective was to describe financial distress screening and financial navigation across National Cancer Institute Community Oncology Research Program (NCORP) practices treating AYAs with cancer.
METHODS: The 2022 NCORP Landscape Assessment was developed and refined by an expert committee to assess infrastructure and capacity to conduct oncology research. Survey items specific to financial distress screening and cancer-specific financial navigation were compared on the basis of practice and patient characteristics among practices treating AYAs.
RESULTS: A total of 271 NCORP practices (45 of 46 NCORP sites; 517 of 1,000+ discrete clinics) responded to the survey April through June 2022. One-hundred practices (37.0%) were characterized as treating AYAs. Most practices reported routinely screening for financial distress (82.0%) via social worker evaluation (57.0%). Financial concerns were addressed via social workers (81.0%), cancer-specific financial navigation (47.0%), billing staff (46.0%), general financial navigation (35.0%), or outside case management (31.0%). A lower proportion of practices with access to cancer-specific financial navigation reported having a dedicated AYA program (10.6% v 28.3%, odds ratio [OR], 0.30 [95% CI, 0.10 to 0.91]; P = .028) or treating >30% of patients insured by Medicaid (6.4% v 26.4%, OR, 0.19 [95% CI, 0.05 to 0.71]; P = .008) compared with those without cancer-specific financial navigation.
CONCLUSION: Although most NCORP practices treating AYAs reported routinely screening for financial distress, only one half of practices offer cancer-specific financial navigation. Practices treating a higher percentage of patients at greatest risk for financial hardship have less access to cancer-specific financial navigation. Further research is needed to support expansion of financial navigation services among community oncology practices that treat AYAs.
PMID:41197082 | DOI:10.1200/OP-25-00389
