Background: Medical financial hardship (MFH) in cancer survivors is well-documented. Little is known about how disability impacts healthcare needs and costs in cancer survivorship. We examined associations of disability and MFH among survivors in the US. Methods: We identified cancer survivors ≥18 years with (n=2,795) and without (n=12,263) a disability from the National Health Interview Survey 2019 to 2022. The Washington Group Short Set, a validated six-item measure intended to describe the functional status of adults (e.g. disability in seeing, hearing, or walking) was used to identify those with disabilities. MFH was categorized into three domains: 1) material (e.g. problems paying medical bills), 2) psychological (e.g. worrying about medical bills), and 3) behavioral (e.g. delaying/forgoing care due to cost). Adjusted logistic regressions were used to examine associations of disability and MFH among cancer survivors. Results: Cancer survivors with a disability were more likely to experience any MFH (57.2% vs. 47.0%, p<0.05) or any individual domain (Material: 26.4% vs. 13.3%, p<0.05; Psychological: 50.5% vs. 43.0%, p<0.05; Behavioral: 23.2% vs. 12.9%, p<0.05) compared with those without a disability. In addition, survivors with a disability were more likely to report experiencing multiple domains of MFH (29.1% vs. 15.9%; p<0.05). Conclusions: Cancer survivors with a disability face higher risks of MFH. Our findings can inform interventions alleviating MFH in this especially vulnerable population.

Note: In adjusted analyses, covariates included age, sex, race/ethnicity, marital status, education, family income as % of Federal Poverty Level, insurance, year, and survey design; AME=Average Marginal Effect; CI = Confidence Interval.