For generations, the words ‘You have cancer‘ have been among the most dreaded in the English language. Yet for millions of Americans, a new fear is rivaling — and often overtaking — the terror of the disease itself: the fear of how they’ll pay for treatment.
Recent surveys reveal a striking reality: nearly 70% of Americans are just as afraid of the financial burden of cancer as they are of the diagnosis. This phenomenon, known as ‘financial toxicity,’ affects nearly every aspect of care. Patients report skipping screenings, delaying or discontinuing treatments, and making painful financial sacrifices — all because of cost concerns.
Studies show that US health care costs are driven by high prices, administrative inefficiencies, and chronic disease management. According to the U.S. Centers for Disease Control and Prevention (CDC), these high costs, which are by far the highest among developed nations, fuel significant societal impacts, including rising out-of-pocket burdens, increased income inequality, and financial barriers to care. [1][2][3][4][5] And the underlying numbers are sobering:
- 69% of Americans are very concerned about paying for cancer treatment if diagnosed.
- The fear of treatment costs (69%) is nearly identical to the fear of dying from cancer (68%).
- 24% of patients admit to skipping, delaying, or stopping treatment due to financial anxiety.
- Over 80% of patients make financial sacrifices, including using up savings (44%), taking on credit card debt (36%), or postponing care (24%).
- End-of-life cancer care can exceed $100,000 per patient in the final year alone.
Cost Concerns Now Rival Diagnosis Anxiety
Data from the Prevent Cancer Foundation’s 2026 Early Detection Survey */** paints an even clearer picture: more than one in three adults (34%) say their main worry about cancer screenings is cost (up from 25% in 2025), matching the number who fear being diagnosed. This marks a significant jump from previous years and is driving a crisis of delayed detection.
Nearly three-quarters of U.S. adults are now behind on at least one recommended routine cancer screening (19%), with 35% citing cost as a top barrier (Others cited skepticism about the health care system as the reason for not completing their screening). Many are confused about what will actually be covered by insurance, and half of those who skip screenings for financial reasons report worries about the cost of the screening or appointment itself. Others worry about follow-up care, missing work, or lost income.
And while most of these reasons fall just behind not knowing they needed to be screened (42%) and not having a family history of the disease (36%), nearly half (49%) of the respondents said that they mistrust the healthcare system based on their belief that the health care system prioritizes profit over patient care, while yet another group pointed to past negative experiences—including unclear or conflicting information.
A common misconception
“Cost concerns continue to be a major barrier—not because screenings are always expensive, but because people don’t have clear information about what’s covered,” said Jody Hoyos, Chief Executive Officer of the Prevent Cancer Foundation.
“When fear and confusion stop people from getting screened, we lose the chance to prevent cancer or catch it early, when it’s easier to treat. We lose the chance to save lives.”
Misinformation or incomplete information can also lead to misconceptions about screening.
One common misconception is that only people with a family history of cancer need to get screened. The facts are different.
“Most cancers occur in people with no family history of disease. In fact, only about 5% to 10% of all cancers are hereditary,” said Heather Mackey, Senior Director of Cancer Prevention and Early Detection at the Prevent Cancer Foundation.
“While it is important to know your family history so you can discuss screening initiation, intervals, and frequency with your health care provider, everyone needs to get their routine screenings, with or without a family history of cancer,” added Mackey, who was interviewed in 2025.
The Domino Effect of Medical Debt
But the consequences for fear of health-related costs don’t stop at delayed detection. Medical debt is becoming a defining feature of American life, especially for those facing cancer. Debt is three to four times higher in counties with the highest disease burden. It deepens racial and generational disparities and prevents families from saving for retirement, investing in education, or even buying a home.
For the sickest patients, the fear of debt is a literal barrier to care:
- About 1 in 7 people with medical debt have been denied access to providers due to unpaid bills.
- Two-thirds of those in debt have put off care for themselves or a family member because of cost.
In a 2022 interview with Noam Levey for Kaiser Health News (KHN), a national newsroom that produces in-depth journalism about health issues, and published in Onco’Zine, Miriam Atkins, MD, a Georgia oncologist, described the situation as “It’s barbaric.” Like many physicians, Atkins has seen patients abandon potentially life-saving treatments out of fear of bankruptcy.[6]
A System Out of Balance
These fears persist despite the Affordable Care Act, which expanded insurance but also led to rising deductibles and out-of-pocket costs. As hospitals and insurers post record profits, patients shoulder more of the burden than ever before.
Compounding the problem is a lack of clear information. Many routine cancer screenings are fully covered by insurance, Medicaid, or Medicare — but confusion and mistrust keep people away from early detection that could save their lives and lower costs.
Early detection
Detecting cancer early can also offset costs in the long run. More than one in four (27%) adults who worried about the cost of screening expressed concern that cancer is expensive to manage. But by detecting cancer at earlier, more treatable stages, not only do health outcomes improve, but costs can be dramatically reduced, with lower out-of-pocket expenses and fewer expensive treatments for patients.
Despite ongoing concerns about cost, survey results also point to clear opportunities for progress. These findings reinforce the critical role that health care providers play in building trust and closing information gaps regarding screening coverage, as many people who express skepticism toward the health care system still report trusting their own health care provider.
What Can Be Done?
- Better Information: Health providers must communicate clearly about the cost of screenings and what insurance covers.
- Building Trust: Many patients mistrust the broader health system but still trust their own doctors. Providers are key to closing knowledge gaps.
- Policy Solutions: Addressing high deductibles, surprise bills, and coverage gaps is essential to reducing the fear and real burden of cancer costs.
The fear of cancer is deep, but for many Americans, the fear of financial ruin is just as real. Until the health system addresses the crushing costs of cancer care — and the confusion surrounding them — too many people will continue to avoid screenings, delay treatments, and face the disease without the care they need.
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Note: * The Prevent Cancer Foundation commissioned Atomik Research to conduct a survey of 7,510 U.S. adults 21 years of age and older. Researchers implemented several demographic-based quotes in order to achieve sample characteristics, such as sex, age group classification, and race/ethnicity, similar to the overall U.S. population of adults 21 and older. The margin of error for the overall sample is +/- 1 percentage point at a 95% confidence level. Fieldwork took place between January 10 and January 30 of 2026. Percentages may not add up to 100% due to computer rounding, and/or the acceptance of multiple responses. Atomik Research is an independent market research agency.
* The cancer screenings studied in this survey were for breast cancer, cervical cancer, colorectal cancer, lung cancer, oral cancer, prostate cancer, skin cancer, and testicular cancer.
Patient information: Getting screened for cancer (even if you feel fine) can lead to better health outcomes. To learn more about screening, if you need to be screened, or free and low-cost screenings and tests, visit the patient information site developed by the Prevent Cancer Foundation.
Reference
[1] Anderson GF, Reinhardt UE, Hussey PS, Petrosyan V. It’s the prices, stupid: why the United States is so different from other countries. Health Aff (Millwood). 2003 May-Jun;22(3):89-105. doi: 10.1377/hlthaff.22.3.89. PMID: 12757275.
[2] Anderson GF, Hussey P, Petrosyan V. It’s Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt. Health Aff (Millwood). 2019 Jan;38(1):87-95. doi: 10.1377/hlthaff.2018.05144. PMID: 30615520.
[3] Chang CF, Mirvis DM, Mahmood A. The High Cost of American Health Care: Understanding the Deeper Roots of the Crisis. Health Care Anal. 2026 Mar;34(1):1-12. doi: 10.1007/s10728-025-00554-x. Epub 2025 Dec 15. PMID: 41396237; PMCID: PMC12920308.
[4] Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States. Rand Corp.; 2017.
[5] National health expenditure data: historical. Center for Medicare & Medicaid Services. Updated December 18, 2024. Online. Last accessed on April 1, 2026
[6] Levey NN. Diagnosis Debt: 100 Million People in America Are Saddled With Health Care Debt. Onco’Zin, June 16, 2022. Online. Last accessed on April 1, 2026.
Feature image: © 2026 Prevent Cancer Foundation, Used with permission.
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