Rising rates of breast cancer among working-age Australian women have prompted urgent calls for action to address the growing impact of financial toxicity.
Financial toxicity describes the negative impact of out-of-pocket costs, indirect costs and the changing financial circumstances of an individual and their household due to cancer, affecting decisions which can lead to suboptimal treatment outcomes.[i]
Research by Monash University shows the economic impact of breast cancer in Australia is vast. Working-age Australian women diagnosed with breast cancer collectively lose an average of 1.5 years of full-time work for every person diagnosed, costing billions in wages and gross domestic product.[ii]
Zanfina Ademi, Professor of Health Economics at Monash University who co-authored the research report, says the impact of breast cancer on women's productivity is profound.
"Despite the five-year breast cancer survival rate in Australia being over 90%, the average woman may lose approximately 50% of her productive paid work time due to absenteeism and presenteeism due to their cancer," explains Professor Ademi. "This has major implications not only for women's capacity to earn income following diagnosis, but also for broader economic costs to society."
In Australia, breast cancer incurs the highest healthcare expenditure of any tumour type, with over AU$1.5 billion spent on breast cancer screening and treatment in 2020–21.[iii]
Out-of-pocket costs can range from a few hundred to tens of thousands of dollars, and can financially cripple cancer patients and their families, especially when one or more people are unable to work within the household.[iv]
Karen Price, CEO of Breast Cancer Trials and a member of the NSW Government Women's Advisory Council, said that the financial impacts associated with the most diagnosed cancer in women are both short and long-term.
"We know we have a gender pay gap, and women's superannuation balances are lower than that for men. The nature of breast cancer treatment in the short term, the impact on the ability to work, and health issues arising from side effects which can persist over a long time, all create health care expenses and loss of earnings for women, some of whom are in the peak of their careers. This exacerbates women's financial inequality and independence – an issue that can literally alter the course of a woman's life."
Research suggests more than 50% of patients also report a reduction in their household income after diagnosis of cancer, and 1 in 3 patients reported ceasing work or retiring due to the diagnosis and/or treatment.[v]
Alarmingly, nearly a quarter of people with a chronic condition, including cancer, report not receiving recommended care due to the associated costs.[vi]
Dr Deme Karikios, medical oncologist at Nepean Hospital and member of the Clinical Oncology Society of Australia (COSA) Financial Toxicity Working Group, says, "Improving our understanding of how individual patients and their doctors think, communicate and decide about expensive treatments could help minimise financial harms that are unexpected or unnecessary."
The Monash University study found that around 10,700 working-age Australians (mostly women) were diagnosed in 2022 — with the cohort expected to lose a collective 16,400 productivity-adjusted life years (PALYs) over the following decade. That loss corresponds to roughly AU$1.4 billion in wage earnings and AU$3.26 billion in GDP over ten years — a sobering illustration that the cost of cancer extends far beyond hospital bills.
"As cancer treatments improve and survival rates continue to rise, we must shift greater attention toward long-term wellbeing and economic participation," adds Professor Ademi. "Survivorship is not just about living longer, it is about living well."
Professor Ademi and Dr Karikios will join a panel of experts in breast cancer research and treatment, support services and lived experience of the disease for Breast Cancer Trials' free online Q&A, 'The Financial Impact of Breast Cancer,' on Wednesday from 5-6:30pm (AEST). Moderated by Author and Journalist, Annabel Crabb, the event will offer important insights and real-world discussion about the financial realities faced by people diagnosed with breast cancer, drawing on the latest in research and real-life experiences.
Participants can register for the Q&A here.
[iv] Australian Experiences of Out-of-Pocket Costs and Financial Burden Following a Cancer Diagnosis: A Systematic Review
[v] https://www.cosa.org.au/media/314448/cosa-media-release-financial-burden-of-cancer-treatmentfinal.pdf
[vi] Australian Institute of Health and Welfare. Health expenditure. Canberra: AIHW; 2023.
www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure; Cummins J, Crabbe A, Samuell D, Visser D. The cost of care whitepaper. Sydney (AU); 2021. www.zurich.com.au/content/dam/au-documents/files/advisers/cost-of-care-whitepaper.pdf
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Founded in 1978, Breast Cancer Trials conducts a multicentre national and international clinical trials research program into the treatment and prevention of breast cancer. The work of Breast Cancer Trials has improved the treatment of breast cancer, led to changes in the way breast cancer is managed and has saved thousands of lives. More than 1,000 researchers in 118 institutions across Australia and New Zealand are committed to the vision of no more lives cut short.
