Real-World Evidence of Disproportionate Financial Toxicity and Health-Related Social Needs Among Adolescents and Young Adults Receiving Care at an NCI-Designated Cancer Center
Simple Summary Adolescents and young adults (AYAs, ages 15–39) with cancer face distinct financial challenges—limited savings, unstable jobs, and insurance gaps—that increase their risk of financial distress and unmet health-related social needs. Using routine electronic screening and billing data from 81,731 patients (5655 AYAs), this study found AYAs were significantly more likely than older or younger patients to report medium/high financial strain, carry unpaid medical debt, and need pre-visit financial review due to unpaid bills; those aged 26–32 showed the highest burden of financial risk, unresolved balances, collection referrals or write-offs, and food insecurity. These findings identify AYAs as a high-risk group for financial toxicity and health-related social needs, supporting the development of targeted interventions, policy changes to reduce economic barriers to care, and future research on tailored support programs for adolescent and young adult cancer patients.