Retrospective analysis of the association between county-level medical debt and treatment initiation among individuals newly diagnosed with cancer

High costs of cancer care may lead to medical debt for patients and families. Retrospective analysis of the 2012-2021 Colorado Center Cancer Registry linked to the Colorado All-Paye Claims Database examined the association of county-level medical debt and timely treatment initiation among 35,789 adults newly diagnosed with cancer. The analysis found that higher county-level medical debt was associated with lower likelihood of timely treatment initiation for all cancers combined (Q4 versus Q1: HR 0.916; p for trend 0.001), for female breast cancer (HR 0.910; p for trend 0.011), and among individuals aged 19-64 years with private health maintenance organization plans (HR 0.869; p for tren 0.002) or Medicaid coverage (HR 0.869; p for trend 0.013). The authors conclude that policies aimed at preventing and alleviating medical debt could be effective strategies for improving access to timely treatment.