title: The right to be forgotten: a change in access to insurance and loans after childhood cancer?
abstract: OBJECTIVE
  Access to insurance for a loan or a mortgage is an important issue for childhood cancer survivors. The aim of this study was to describe difficulties experienced by adult survivors.
  
  
  METHODS
  A total of 1920 survivors treated before the age of 18 in five French cancer centers responded to a questionnaire in 2010. Survivors who had tried to obtain a loan were asked if they had experienced difficulties, which were defined as experiencing rejection, higher premiums, or exclusions. The questionnaire investigated health problems related to the circulatory, respiratory, digestive, urinary, endocrine, hormonal, and nervous systems. Second tumors, diabetes mellitus, cardiac disease, and stroke were ascertained from a physician's report or medical records. Multivariable analyses were conducted to identify the characteristics of survivors reporting difficulties.
  
  
  RESULTS
  Difficulties were experienced by 10.4% of those who had tried to obtain a small loan (n = 787) and by 30.1% of those who had tried to obtain a home loan (n = 909). Disclosure of childhood cancer to the insurer and amputation surgery were negatively associated with insurance accessibility, even when controlling for age, gender, education, health-related unemployment, familial situation, and severe or life-threatening conditions such as cardiovascular diseases, second cancers, or diabetes.
  
  
  CONCLUSIONS
  This study showed that the financial burden of cancer can extend decades after diagnosis.
  
  
  CONCLUSIONS
  Thanks to a 2016 law, French cancer survivors no longer have to disclose their cancer to insurers after a fixed number of years. This law will probably lessen the socioeconomic burden of cancer.
authors.affiliation: Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France. agnes.dumas@gustaveroussy.fr.|Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France. agnes.dumas@gustaveroussy.fr.
authors.forename: Agnès
authors.initials: A
authors.lastname: Dumas
authors.affiliation: Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.|Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Rodrigue
authors.initials: R
authors.lastname: Allodji
authors.affiliation: Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.|Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.|Department of Paediatric and Adolescent Oncology, Gustave Roussy, 94805, Villejuif, France.
authors.forename: Brice
authors.initials: B
authors.lastname: Fresneau
authors.affiliation: Department of Paediatric and Adolescent Oncology, Gustave Roussy, 94805, Villejuif, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Valteau-Couanet
authors.affiliation: Department of Paediatric and Adolescent Oncology, Gustave Roussy, 94805, Villejuif, France.
authors.forename: Chiraz
authors.initials: C
authors.lastname: El-Fayech
authors.affiliation: Department of Paediatric Oncology, Institut Curie, 75005, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Pacquement
authors.affiliation: Department of Radiation Oncology, Centre Claudius Regaud, 31059, Toulouse, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Laprie
authors.affiliation: Radiotherapy Department, Centre Jean Godinot, 51100, Reims, France.
authors.forename: Tan Dat
authors.initials: TD
authors.lastname: Nguyen
authors.affiliation: Department of Radiation Oncology, Centre Antoine Lacassagne, 06100, Nice, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Bondiau
authors.affiliation: Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.|Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Diallo
authors.affiliation: Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.|Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Guibout
authors.affiliation: Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.|Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Rubino
authors.affiliation: Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.|Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Nadia
authors.initials: N
authors.lastname: Haddy
authors.affiliation: Department of Paediatric and Adolescent Oncology, Gustave Roussy, 94805, Villejuif, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Oberlin
authors.affiliation: Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Vassal
authors.affiliation: Centre for Research in Epidemiology and Population Health (CESP), Cancer and Radiation team, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, 94807, Villejuif, France.|Department of Clinical Research, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Florent
authors.initials: F
authors.lastname: de Vathaire
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D011788:Quality of Life; D015996:Survival Rate
keywords: Cohort studies; Discrimination; Economic burden of disease; Long-term adverse effects; Quality of life; Survivorship