Out-of-pocket costs for cancer survivors between 5 and 10 years from diagnosis: an Italian population-based study

Paolo Baili, Francesca Di Salvo, Francesco De Lorenzo, Francesco Maietta, Carmine Pinto, Vera Rizzotto, Massimo Vicentini, Paolo Giorgi Rossi, Rosario Tumino, Patrizia Concetta Rollo, Giovanna Tagliabue, Paolo Contiero, Pina Candela, Tiziana Scuderi, Elisabetta Iannelli, Stefano Cascinu, Fulvio Aurora, Roberto Agresti, Alberto Turco, Milena SantElisabetta Meneghini, Andrea Micheli

Research output: Contribution to journalArticlepeer-review


PURPOSE: To illustrate the out-of-pocket (OOP) costs incurred by a population-based group of patients from 5 to 10 years since their cancer diagnosis in a country with a nationwide public health system.

METHODS: Interviews on OOP costs to a sample of 5-10 year prevalent cases randomly extracted from four population-based cancer registries (CRs), two in the north and two in the south of Italy. The patients' general practitioners (GPs) gave assurance about the patient's physical and psychological condition for the interview. A zero-inflated negative binomial model was used to analyze OOP cost determinants.

RESULTS: Two hundred six cancer patients were interviewed (48 % of the original sample). On average, a patient in the north spent €69 monthly, against €244 in the south. The main differences are for transport, room, and board (TRB) to reach the hospital and/or the cancer specialist (north €0; south €119). Everywhere, OOP costs without TRB costs were higher for patients with a low quality of life.

CONCLUSIONS: Despite the limited participation, our study sample's characteristics are similar to those of the Italian cancer prevalence population, allowing us to generalize the results. The higher OOP costs in the south may be due to the scarcity of oncologic structures, obliging patients to seek assistance far from their residence. Implications for cancer survivors Cancer survivors need descriptive studies to show realistic data about their status. Future Italian and European descriptive studies on cancer survivorship should be based on population CRs and involve GPs in order to approach the patient at best.

Original languageEnglish
Pages (from-to)2225-33
Number of pages9
JournalSupportive Care in Cancer
Issue number5
Publication statusPublished - May 2016


  • Aged
  • Aged, 80 and over
  • Female
  • Health Expenditures
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Neoplasms
  • Quality of Life
  • Surveys and Questionnaires
  • Survivors
  • Time Factors
  • Journal Article
  • Research Support, Non-U.S. Gov't


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