This is the first study to provide national estimates of medical expenditures for all adult cancer survivors under age 65. Most studies of expenditures for cancer survivors in this age group have been based on the Medical Expenditure Panel Survey and limited to “affected survivors.”

MEPS expenditure data for 2001 to 2007 were linked to data identifying all survivors from the National Health Interview Survey, the MEPS sampling frame. The sample was adults 25–64 years old. Propensity-score matching was used to estimate the effects of cancer on average total and out-of-pocket expenditures for all services, and prescriptions separately. Probit models were used to estimate effects on the probability of exceeding different expenditure thresholds.

Mean annual expenditures on all services in 2007 were $16,910 ± $3911 for survivors newly diagnosed with cancer, $7992 ± $972 for survivors diagnosed in previous years, and $3303 ± $103 for other adults. Fifty-three percent of survivors were not identified in MEPS, but only by linking to NHIS. Expenditures for all survivors averaged about $9300, compared to $13,600 for “affected survivors.” For previously diagnosed survivors, the increase in mean expenditures attributable to cancer was about $4000-$5000 annually. On average, relatively little of the increase was paid out of pocket, but cancer nearly doubled the risk of high out-of-pocket expenditures.

Previous MEPS analyses overstated average expenditures for all survivors. Nevertheless, the increase in expenditures attributable to cancer is substantial, even for longer term survivors. Cancer increases the relative risk of high out-of-pocket expenditures.