According to the American Cancer Society, there are an estimated 650,000 adolescent and young adult cancer survivors in the U.S. Cancer survivorship is often accompanied by long-lasting financial impact, and this is especially true for adolescent and young adult cancer survivors diagnosed between the ages of 15 and 39.
To help address the risk of financial hardship to this group, researchers at Wake Forest University School of Medicine have been awarded a five-year, $3.2 million grant from the National Cancer Institute (NCI), part of the National Institutes of Health, to test a multilevel intervention in community-based oncology practices in the NCI’s Community Oncology Research Program (NCORP), a national network that brings cancer clinical trials and care delivery studies to communities.
Atrium Health Wake Forest Baptist’s National Cancer Institute-designated Comprehensive Cancer Center, part of Wake Forest University School of Medicine, is one of seven NCORP research bases.
“This age group is at disproportionately greater risk of financial hardship during survivorship when compared to older adult cancer survivors or families of pediatric cancer survivors,” said John Salsman, Ph.D., professor of social sciences and health policy at Wake Forest University School of Medicine and co-principal investigator of the study. “They may experience significant disruptions in their education and/or vocational pursuits, which can impact their earnings.”
In addition to career interruption, this group might also have inadequate insurance coverage and limited financial assets, Salsman said.
With the funding support, the research team will blend two known interventions:
- CHAT (Let’s CHAT About Health Insurance) is a program designed by Anne Kirchhoff, Ph.D., from the University of Utah, and colleagues to educate adolescent and young adult cancer survivors about health insurance.
- Lessening the Impact of Financial Toxicity (LIFT) is a program designed by Stephanie Wheeler, Ph.D., from the University of North Carolina at Chapel Hill, and colleagues to systematically assess cancer patients’ eligibility and coordinate access to financial support resources.
“Our first objective is to take these interventions to create a new program that is user-friendly, effective and appropriate for adolescent and young adult cancer survivors,” said Sarah Birken, Ph.D., associate professor of implementation science at Wake Forest University School of Medicine and co-principal investigator of the study. “We want to target the multiple levels, organizational and individual, that contribute to financial hardship.”
The research team will conduct a randomized controlled trial of the blended program, called FinFit, at community oncology practices affiliated with NCORP.
According to Salsman, most individuals with cancer receive treatment in community-based practices, but relatively little research in adolescent and young adult oncology occurs in these settings. Conducting this trial in the NCORP setting will provide an opportunity to address financial hardship among cancer survivors who are most in need.
Enrollment in the trial is expected to begin in July 2025 with an enrollment goal of 408 participants.
“Our results will guide future efforts to scale FinFit more broadly,” Birken said. “And hopefully, we’ll find that FinFit meets the unique needs of this population while addressing the factors that contribute to financial hardship.”
Atrium Health Wake Forest Baptist’s Comprehensive Cancer Center is marking 50 years of NCI designation.
Media Contact: Myra Wright, mgwright@wakehealth.edu