Cost of Cancer: Out-of-pocket expenses eat into two-in-five patients’ retirement savings

One-third face challenging cancer journeys because of career setbacks, barriers to treatment


Pour la version française, cliquez ici.

February 4, 2025 – Cancer touches nearly all Canadian lives at some point or another, whether through a personal diagnosis – approaching half (45%) will be diagnosed with cancer at some point in their lifetimes – or experiencing it second-hand through a friend or family member.

However, there remains an underreported burden of the disease – the financial costs of cancer treatment that occur despite Canada’s public health-care system.

New data from the non-profit Angus Reid Institute in partnership with the Canadian Cancer Society finds one-quarter (23%) of Canadians diagnosed with cancer reporting they faced “substantial out-of-pocket costs”, which caused difficulties making ends meet.

One-in-five (21%) say it was difficult to pay their household expenses and others struggled with their rent (17%) or mortgage payments (13%). But perhaps the greatest impact out-of-pocket costs had on Canadians was on retirement savings. Two-in-five (40%) cancer patients report that portion of their budget suffered as they dealt with treatment.

These out-of-pocket costs came as many cancer patients – and those who know a family member, friend or colleague with cancer – report career difficulties followed a diagnosis. Among working age Canadians with proximity to cancer, three-in-ten (31%) say a cancer diagnosis required “significant unpaid time off”, while seven per cent say a cancer diagnosis cost themself or a loved one career advancement opportunities. One-in-ten (10%) say they, or someone they know, lost their job while they were in treatment for cancer.

In the wake of dueling ongoing crises of a rising cost of living, and a strained health-care system, this report includes a Cancer Experience Index (CEI), which assesses Canadians’ barriers and challenges while going through their cancer treatment journey. Factoring in difficulties such as the career setbacks and job loss, as well as struggles and delays with accessing diagnosis, treatment and care, more than one-third (37%) of those personally diagnosed with cancer have faced challenging or very challenging treatment journeys. This data is further reinforced by the two-in-five (39%) of those who know close friend, colleague or family member who diagnosed with cancer and report similar struggles with access to care and career challenges.

More Key Findings:

  • At an already difficult time in their life as they deal with cancer diagnosis, a majority of Canadians who have had cancer themselves, or are close to someone diagnosed, say that financial setbacks including unpaid time off or job loss had a “major” negative effect on their or a close friend or family member’s mental health.
  • Most Canadians (56%) believe either their provincial government (38%) or the federal government (18%) should bear the main responsibility for bearing out-of-pocket costs related to cancer care. Few (7%) say it should fall to the cancer patients themselves.
  • Asked how they would financially handle an additional $260 per month due to out-of-pocket costs from cancer treatment, four-in-five (77%) working age Canadians who have not been diagnosed say it would be difficult for them to save for retirement in such a scenario. As well, more than two-in-five of this group say the additional costs of cancer treatment would make covering rent (44%) or their mortgage (45%) difficult.

 

INDEX

Part One: Cancer in Canada

  • Assessing Canadians’ proximity to cancer

Part Two: The impacts and costs of diagnosis

  • Career consequences and out-of-pocket costs

  • Two-in-five say financial costs of their cancer treatment ‘difficult’

  • Cancer Experience Index – one third face challenges after diagnosis

  • Most Canadians say it would be ‘difficult’ to handle out-of-pocket costs

Part Three: Addressing out-of-pocket costs

  • Most believe government should alleviate out-of-pocket cancer expenses

 

Part One: Cancer in Canada

Assessing Canadians’ proximity to cancer

Cancer is widely prevalent in Canada. Approaching half (45%) of Canadians are expected to receive a cancer diagnosis in their lifetime, while cancer remains the leading cause of death, accounting for one-quarter of all deaths in a typical year in Canada.

As of 2018, 1.5 million Canadians had been diagnosed with cancer in the previous 25 years, representing four per cent of the population at the time. A decade previous to that, it was estimated one million Canadians were living cancer, representing the growth in both the number of cases being diagnosed in Canada each year as well as an increasing survival rate for cancer overall.

Nine-in-10 Canadians (90%) know someone who has been diagnosed with cancer, including three-in-five (63%) who say it was a household or close family member, one-quarter who say it was a close friend (24%), and one-third (32%) who say it was a colleague or acquaintance. Within the sample, one-in-ten (9%) say they’ve been previously diagnosed with cancer themselves.

Those older than 50 make up nine-in-10 cancer cases in Canada. Canadians older than 54 are less likely than others to report no personal proximity to the disease (5%). The rates of Canadians reporting a close friend with a diagnosis also rises with age:

Canadians’ experience with cancer is not limited to knowledge of someone else’s diagnosis. Half (49%) of Canadians who know someone personally who was diagnosed with cancer say they’ve provided emotional support, while one-quarter (26%) have provided practical care, one-in-five (21%) physical care and eight per cent financial support to those who have been diagnosed.

Part Two: The impacts and costs of diagnosis

Career consequences and out-of-pocket costs

The primary concern of those with a cancer diagnosis is health, but there are secondary financial effects Canadians experience as they undergo treatment. The ramifications of extended treatment can include unpaid time off, missing out on career advancement opportunities, demotions, or even job loss, and that is on top of the potential of out-of-pocket costs. All in all, when lost income is factored in, the Canadian Cancer Society estimates that cancer costs the average patient $33,000 in their lifetime.

Meanwhile, the incidence of cancer in people under 50, who make up one-in-10 cancer cases in Canada, has been rising. Globally, early-onset cancer has increased by 79 per cent between 1990 and 2019, which puts a brighter spotlight on the potential career implications of a cancer diagnosis.

Among those personally diagnosed, one-quarter (23%) suffered substantial out-of-pocket costs, one-in-five (19%) say they had to take unpaid time off, one-in-20 say their career suffered from lost opportunities or demotion, and one-in-12 (8%) say they lost their job altogether.

These experiences are more commonly reported among those who say they know close friends or colleagues who were diagnosed with cancer, especially among working age Canadians:

*Smaller sample size. Included to provide the perspective of those personally diagnosed with cancer but interpret with caution

The financial burden of the above experiences is one matter, but lost income and career penalties also come with a mental health cost for those already going through the trying experience of a cancer diagnosis. For those who say they, or someone they know, experienced substantial out-of-pocket costs, lost income, lost opportunities or a lost job because of their diagnosis, a majority say it had a profound negative impact on their mental health:

*Smaller sample size. Included to provide the perspective of those personally diagnosed with cancer but interpret with caution

The experiences of those with proximity to cancer provide an interesting juxtaposition with the expectations of those who are further from the experience of a cancer diagnosis. Those who had not been diagnosed themselves, and do not know a close friend or family member who had the disease, say they expect they would need to incur substantial out-of-pocket costs (75% believe it would be very likely or likely) or need to take significant unpaid time off from their job (59%). However, Canadians are less certain there would be potentially more serious career implications such as job loss or a demotion:

Two-in-five say financial costs of their cancer treatment ‘difficult’

Considering all out-of-pocket expenses for cancer treatment, 56 per cent of those who have been diagnosed with cancer say they handled it “easily”. The rest say they experienced some (24%) or a lot (13%) of financial difficulty while one per cent say they couldn’t handle it “at all”:

Overall, the financial challenges brought on by cancer diagnosis appear to have the largest effect on patient’s retirement savings. Two-in-five (40%) of those who have been diagnosed with cancer say out-of-pocket expenses made saving for retirement “difficult”. Difficulties covering other household expenses (21%), non-mortgage debt (23%), mortgage payments (13%) or rent (17%) were reported by fewer, but still sizable minorities of cancer patients:

Cancer Experience Index – one third face challenges after diagnosis

To assess potential challenges and barriers Canadians face when receiving a cancer diagnosis, the Angus Reid Institute and the Canadian Cancer Society created the Cancer Experience Index (CEI). Respondents received negative scores if they reported delayed access to care; required travel out of community, province or country to receive diagnosis or treatment; and financial and employment ramifications from their diagnosis, such as unpaid time off, job loss and significant out-of-pocket costs (see full scoring here). This index was calculated for both those who were personally diagnosed with cancer as well as those who said they knew a family member, close friend or colleague who was diagnosed to ensure a broad range of perspectives were included.

Aggregating both those who personally experienced a cancer diagnosis alongside those who were sharing the experiences of a friend or family member, approximately one-in-12 (8%) Canadians faced a Very Challenging road in their cancer journey. A further three-in-10 (31%) had a Challenging journey, while three-in-five (61%) encountered a Less Challenging one.

Isolating only those who were sharing their personal experience with a cancer diagnosis, similar ratios are seen:

It appears those in rural areas are more likely to encounter barriers and challenges in their experiences with cancer than those living in the country’s urban areas. In Alberta, Saskatchewan, Manitoba and Atlantic Canada, Canadians are more likely to report experiencing or seeing barriers in access to cancer care and significant financial challenges such as unpaid leave or job loss after diagnosis:

Most Canadians say it would be ‘difficult’ to handle out-of-pocket costs

Canadians who have not been personally diagnosed with cancer were asked how they would handle the average lifetime costs of a cancer diagnosis. In the wake of a cost of living and affordability crisis which has persisted in Canada across the past two years, this is a big ask for Canadians. In recent ARI data, Canadians are less likely to report feeling like they are falling behind the rising cost of living, but still two-in-five (38%) believe their finances are worse off than they were the year before.

Related: Economic pessimism declines, but two-in-five say they are ‘worse off’ than last year

Few believe they could absorb the $33,000 out-of-pocket and lost income costs of a cancer diagnosis “easily” (9%). Instead, a majority (59%) say that the added financial burden would cause “a lot of difficulty” (29%) or they would “not at all” (30%) be able to handle it. Women aged 35- to 54-years-old are the most likely to say they would not be able to financially accommodate the cost of the average cancer diagnosis at two-in-five (42%):

Canadians believe their retirement savings would suffer the most if they were to cover the costs of a cancer diagnosis, which matches the experiences of those diagnosed with cancer detailed above. More than two-thirds of Canadians (68%) say it would be “difficult” or “very difficult” to put away money for their post working life if they incurred monthly out of pocket expenses of $260 or more a month. Three-in-five (60%) say paying their monthly household expenses in general would be hard, while most who have mortgage payments (40%) or rent (41%) to pay also say any additional costs from a cancer diagnosis would make those obligations harder to cover:

Part Three: Addressing out-of-pocket costs

Most believe government should alleviate out-of-pocket cancer expenses

The “free” aspect of Canada’s public health-care system has been under strain given the struggles of health care across the country in the post-pandemic era. In 2022, three-in-10 (29%) of Canadians reported chronic difficulty in accessing the health-care system despite needing treatment. Provinces have experimented with more private delivery, but half of Canadians in 2022 worried that would worsen a system already in decline.

Related:

Despite these struggles, there appears to be an expectation that Canadians themselves should not be financially burdened by being diagnosed with disease. When asked who should bear the main responsibility for currently uncovered costs of cancer care, a majority (56%) select either their provincial government (38%) or the federal government (18%). One-in-five (21%) believe it should fall under insurance policies. Fewer than one-in-10 (7%) believe it should be the cancer patients themselves who are burdened with additional out-of-pocket costs while going through treatment:

When asked where government resources should be allocated, Canadians who have personally experienced cancer and those who have not are largely aligned: majorities believe there should be government investment in increased cancer screening, while at least two-in-five in each group believe it’s most important for government money to be invested in covering out-of-pocket costs and increased access to primary health care.

Those who have experienced cancer are much more likely to believe the government should invest more in new cancer drugs (31%) than those who have not received a cancer diagnosis (19%), while placing less of a priority on extended job leave (20% vs. 28%) and covering more out-of-pocket costs (40% vs. 49%):

Survey Methodology:

The Angus Reid Institute and the Canadian Cancer Society conducted an online survey from Jan. 10-17, 2025 among a representative randomized sample of 2,044 Canadian adults who are members of Angus Reid Forum. For comparison purposes only, a probability sample of this size would carry a margin of error of +/- 1.5 percentage points, 19 times out of 20. Discrepancies in or between totals are due to rounding. The survey was self-commissioned and paid for by ARI and CCS.

About ARI

The Angus Reid Institute (ARI) was founded in October 2014 by pollster and sociologist, Dr. Angus Reid. ARI is a national, not-for-profit, non-partisan public opinion research foundation established to advance education by commissioning, conducting and disseminating to the public accessible and impartial statistical data, research and policy analysis on economics, political science, philanthropy, public administration, domestic and international affairs and other socio-economic issues of importance to Canada and its world.

About the Canadian Cancer Society  

The Canadian Cancer Society works tirelessly to save and improve lives. We raise funds to fuel the brightest minds in cancer research. We provide a compassionate support system for all those affected by cancer, across Canada and for all types of cancer. Together with patients, supporters, donors and volunteers, we work to create a healthier future for everyone. Because to take on cancer, it takes all of us. It takes a society. 

Help us make a difference. Call 1-888-939-3333 or visit cancer.ca today. 

For detailed results by age, gender, region, education, and other demographics, click here.

For detailed results by proximity to cancer and the Cancer Experience Index, click here.

For full release including methodology, click here

For questionnaire, click here.

Pour la version française, cliquez ici.

MEDIA CONTACT:

Shachi Kurl, President, ARI: 604.908.1693 shachi.kurl@angusreid.org @shachikurl

Victoria Young, Communications Coordinator, CCS: 416-572-4252, victoria.young@cancer.ca

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