International medical tourism of US cancer patients for alternative cancer treatments: Financial, demographic, and clinical profiles of online crowdfunding campaigns

BACKGROUND

Previous research has found that individuals may travel outside their home countries in pursuit of alternative cancer therapies (ACT). The goal of this study is to compare individuals in the United States who propose plans for travel abroad for ACT, compared with individuals who seek ACT domestically.

METHODS

Clinical and treatment data were extracted from campaign descriptions of 615 GoFundMe® campaigns fundraising for individuals in the United States seeking ACT between 2011 and 2019. We examined treatment modalities, treatment location, fundraising metrics, and online engagement within campaign profiles. Clinical and demographic differences between those who proposed international travel and those who sought ACT domestically were examined using two-sided Fisher's exact tests. Differences in financial and social engagement data were examined using two-sided Mann-Whitney tests.

RESULTS

Of the total 615 campaigns, 237 (38.5%) mentioned plans to travel internationally for ACT, with the majority (81.9%) pursuing travel to Mexico. Campaigns that proposed international treatment requested more money ($35,000 vs. $22,650, p < 0.001), raised more money ($7833 vs. $5035, p < 0.001), had more donors (57 vs. 45, p = 0.02), and were shared more times (377 vs. 290.5, p = 0.008) compared to campaigns that did not. The median financial shortfall was greater for campaigns pursuing treatments internationally (-$22,640 vs. -$13,436, p < 0.003).

CONCLUSIONS

Campaigns proposing international travel for ACT requested and received more money, were shared more online, and had more donors. However, there was significantly more unmet financial need among this group, highlighting potential financial toxicity on patients and families.

An integrated assessment framework for climate change and infectious diseases

Many potential human health effects have been hypothesized to result either directly or indirectly from global climate change. Changes in the prevalence and spread of infectious diseases are some of the most widely cited potential effects of climate change, and could have significant consequences for human health as well as economic and societal impacts. These changes in disease incidence would be mediated through biologic, ecologic, sociologic, and epidemiologic processes that interact with each other and which may themselves be influenced by climate change. Although hypothesized infectious disease effects have been widely discussed, there have not yet been thorough quantitative studies addressing the many processes at work. In part this is because of the complexity of the many indirect and feedback interactions or mechanisms that bear on all aspects of the climate issue. It also results from the difficulty of including the multitude of always-changing determinants of these diseases. This paper proposes a framework for an integrated assessment of the impacts of climate change on infectious diseases. The framework allows identification of potentially important indirect interactions or mechanisms, identification of important research gaps, and a means of integrating targeted research from a variety of disciplines into an enhanced understanding of the whole system.

An integrated assessment framework for climate change and infectious diseases

Many potential human health effects have been hypothesized to result either directly or indirectly from global climate change. Changes in the prevalence and spread of infectious diseases are some of the most widely cited potential effects of climate change, and could have significant consequences for human health as well as economic and societal impacts. These changes in disease incidence would be mediated through biologic, ecologic, sociologic, and epidemiologic processes that interact with each other and which may themselves be influenced by climate change. Although hypothesized infectious disease effects have been widely discussed, there have not yet been thorough quantitative studies addressing the many processes at work. In part this is because of the complexity of the many indirect and feedback interactions or mechanisms that bear on all aspects of the climate issue. It also results from the difficulty of including the multitude of always-changing determinants of these diseases. This paper proposes a framework for an integrated assessment of the impacts of climate change on infectious diseases. The framework allows identification of potentially important indirect interactions or mechanisms, identification of important research gaps, and a means of integrating targeted research from a variety of disciplines into an enhanced understanding of the whole system.