Background: Expenditures associated with cancer, its treatment, and lasting effects of treatment are increasing in the US. The purpose of this study is to estimate the prevalence of financial hardship associated with cancer and identify characteristics of cancer survivors associated with financial hardship. Methods: We identified 1,202 cancer survivors ages ≥ 18 years from the 2011 Medical Expenditure Panel Survey (MEPS) Experiences with Cancer survey. Material financial hardship was measured by ever 1) borrowing money or going into debt, 2) filing for bankruptcy, 3) being unable to cover their share of medical care costs, or 4) making other financial sacrifices due to cancer, its treatment or lasting effects of treatment. Psychological financial hardship was measured as worry about paying large medical bills. We examined factors associated with any material or psychological financial hardship using separate multivariable logistic regression models stratified by age group (18-64 and ≥ 65 years). Results: Cancer survivors ages 18-64 years were more likely to report any material financial hardship than those ages ≥ 65 years (28.4% vs 13.8%; p < 0.05). Worry about paying large medical bills was also more common among cancer survivors ages 18-64 years than those ages ≥ 65 years (31.9% vs 14.7%, p < 0.05). In adjusted analyses, cancer survivors ages 18-64 years who were younger, female, non-white, and treated more recently were significantly more likely to report any material financial hardship associated with cancer compared to those who were older, male, non-Hispanic white, and treated less recently. Those who were female, had lower family income, and treated more recently were more likely to report psychological financial hardship. Among cancer survivors ages ≥ 65 years, those who were younger and non-white were more likely to report any financial hardship (all p < 0.05). Conclusions: Cancer survivors commonly experience material and psychological financial hardship. The working age population is especially vulnerable. Efforts to characterize cancer survivors likely to experience financial hardship and improve patient-provider communication about affordability are crucial, especially with ongoing implementation of the Affordable Care Act.