Americans with cancer are turning to online crowdfunding for help with medical bills and basic living expenses — but most fall far short of their fundraising goals.

That’s according to a recent study by the American Cancer Society (ACS) that analyzed over 78,000 cancer-related fundraising campaigns on the popular crowdfunding platform GoFundMe. The main takeaway: Only 11.5% of campaigns met their goals within 90 days; instead, they typically raised about one third of the funds requested.

“It was very rare that a campaign was initiated and received no money,” lead author Jason Zheng, PhD, senior principal scientist of health services research at the ACS, told Medscape Medical News. “However, we identified very low success rates in terms of campaigns reaching fundraising goals.”

Given that there are roughly 18 million cancer survivors in the US, it seems that only a small portion are resorting to GoFundMe, Zheng pointed out. However, the fact that some use crowdfunding to pay their bills is a symptom of a bigger problem.

“Healthcare affordability is certainly an issue, and this study highlights that,” Zheng said. “Unless we try to figure out a way to systematically solve the affordability issue, I think medical financial hardship will continue to be a major problem.”

The findings, published in the Journal of the National Comprehensive Cancer Network, build on prior research showing that a growing number of Americans are resorting to crowdfunding to dig themselves out of medical debt.

The particular financial toxicity of cancer is well documented, with patients’ high out-of-pocket treatment costs often being compounded by travel expenses and lost wages. Americans with a cancer history are more likely than other Americans to forgo or delay prescription medications due to cost, cut down on food spending, go into debt, or declare bankruptcy.

The rising cost of living in recent years has only added to the problem. “People are struggling right now, and it’s really hard to cover healthcare costs alongside everything else that they have to pay for,” said Lynne Cotter, PhD, of the health policy research organization KFF (formerly Kaiser Family Foundation) in San Francisco.

“It makes sense that people might be looking outside the traditional health insurance spectrum to be covering these costs of healthcare,” Cotter, who was not involved in the ACS study, told Medscape Medical News.

While other studies have looked at cancer-related crowdfunding, the ACS research had a broader scope, analyzing detailed donation records at the campaign, state, and national levels.

Zheng’s team evaluated publicly available data from 78,338 cancer-related fundraising campaigns initiated between January 2021 and February 2023 on GoFundMe. The platform accounts for over 90% of the US crowdfunding market, with “medical reasons” being the top campaign category.

The researchers used an artificial intelligence tool that interprets written text (natural language processing) to identify campaign characteristics, analyze fundraiser stories, and extract details about the beneficiary’s demographics, cancer type and stage, time since diagnosis, and treatment information.

Overall, Zheng’s team found, the campaigns raised a large sum: $506 million. But that covered only about one third of what they collectively requested, at $1.47 billion.

On the individual level, campaigns sought to raise a median of $10,000 but received a median of $4000 in donations.

In general, the study found, more donations came into campaigns that described beneficiaries who were younger than 18 years, men, married, living with dependent children, or employed or attending school. However, those campaigns were not necessarily more successful in reaching their goals.

Zheng pointed out that crowdfunding is not simply a go-to for Americans who lack health insurance.

“We found that a lot of people do have health insurance,” he said. “But they still come up short in terms of financial resources to deal with all these financial stresses caused by a cancer diagnosis.”

About 92% of Americans have health insurance. Yet, Cotter noted, roughly 4 in 10 report some kind of healthcare debt, including credit card debt and money owed to family or friends who’ve helped them cover their bills.

Research conducted by KFF, she said, has demonstrated just how easily a US family can fall into medical debt.

“We found that the average American household has about $5000 in liquid assets, but the average deductible for a family can be as high as $16,000,” Cotter said. “Having a hospital stay for one family member could put you over your liquid assets.”

For clinicians, the ACS researchers wrote in the report, the findings underscore the importance of discussing the “economic implications” of a cancer diagnosis with patients — not only treatment costs but also the potential effects on employment and ability to pay nonmedical bills. Care teams, they added, should be able to connect patients and families with social and financial resources when necessary.

The researchers reported receiving no funding source for the study. One co-author disclosed receiving research support from Merck, and another reported serving as a member of the National Comprehensive Cancer Network work group.

Keith Mulvihill is a freelance journalist based in New York City.