The results, based on a survey of more than 2,500 cancer patients across 25 European countries, expose stark disparities both within and between EU member states. The findings underscore the urgent need for better support systems, especially for vulnerable groups like adolescents and young adults (AYA).
All participants had been treated for cancer in the past two years or were still undergoing treatment. More than half (56%) of the participants reported losing income following their diagnosis. A large majority (86%) faced additional costs related to their treatment, such as travel or medications that couldn’t be reimbursed. 16% said they had postponed or skipped doctor visits, surgery, or medication due to financial reasons.
“Postponing or avoiding medical treatment is directly related to healthcare itself. This financial strain on cancer patients is not just a political concern, but also a clinical issue as well as a life event for adolescents and young adults, which should be a structural aspect of health care policies, cancer treatment and follow-up of cancer survivors”, says Wim van Harten, group leader at the NKI.
The impact was even greater among adolescents and young adults. Nearly 80% of patients in this age group reported financial difficulties, and 65% said they had lost income. Many struggled to cover the costs related to their treatment, and a significant number found available support services to be ineffective or only partly helpful.
Importantly, the type of cancer or the specific treatment patients received had little impact on their financial situation, underscoring the systemic nature of these challenges. The results showed that people who were divorced, self-employed, had lower household incomes, or had children at the time of diagnosis were more likely to experience financial hardship. Adolescents and young adult patients are especially affected: out of a sub-group of 577 young people, 79% reported financial difficulties and 65% experienced income loss.
Van Harten: “The socioeconomic consequences of a cancer diagnosis proved to be far more serious than we expected, even in countries with well-established health system coverage and social benefit systems.” Our study warns us that it is a misconception that European social systems protect all patients from the financial consequences of a cancer diagnosis. Especially adolescents and young adult cancer patients are affected, and guidance and services for these patients should be improved.”
The study also highlights how differences in national labour market, social support systems, and healthcare financing models play a significant role in determining the extent of the socioeconomic impact experienced by patients with cancer. In addition to the national employment and social security landscape, the socioeconomic impact of cancer is also affected by specific reimbursement policies and overall healthcare systems.
The NKI team will continue its collaboration with the Organisation of European Cancer Institutes (OECI) and the German Cancer Research Center (DKFZ) in Heidelberg. Building on the lessons from this study, the collaborating institutes have developed a more targeted questionnaire tailored to cancer patients in Europe. This led to a 2024 Lancet Oncology publication outlining clear definitions and a research agenda for addressing financial toxicity in cancer care.
The study, published in ESMO Open with a separate analysis of a subgroup of adolescents and young adults published in the International Journal of Cancer, is the first of its kind to compare the financial and socio-economic impacts of cancer across Europe.