Uninsured or Medicaid-patients are more likely to be
diagnosed with an advanced stage cancer than those with private insurance, a
new study of the American Cancer Society revealed.
Previous studies have shown a correlation between insurance
status and the stage of diagnosis for particular cancers. However, the new
study is the first to examine a dozen major cancer types and to do so
nationally with the most current data.
The research led by Michael Halpern, M.D., Ph.D, strategic
director of health services research used data from the National Cancer
Database, a hospital-based registry capturing patient information from
approximately 1,430 facilities. The researchers analyzed about 3.7 million
patients between ages 18 and 99 who received diagnoses from 1998 to 2004.
The study found significant association between insurance
and stage at diagnosis across multiple cancer sites. The widest disparities
were noted in cancers that could be detected early through standard screening
or assessment of symptoms, like breast cancer, lung cancer, colon cancer, and
melanoma. For each type of cancer, uninsured patients were two to three times
more likely to be diagnosed in Stage III or Stage IV rather than Stage I.
Smaller disparities were found for non-Hodgkins lymphoma and cancers of the
bladder, kidney, prostate, thyroid, uterus, ovary, and pancreas.
“Individuals without insurance are not receiving optimum
care in terms of cancer screening or timely diagnosis and follow-up with health
care providers,” the researchers concluded. Advanced-stage diagnosis “leads to
increased morbidity, decreased quality of life, and survival and, often, increased
costs.”
It is already known that many cancers respond well to
treatment when discovered in their early stages, before cancer cells spread
from one part of the body to other parts. Unfortunately, more advanced cancer
is much harder to treat and much more likely to kill.
The study also showed blacks and to a lesser extent,
Hispanics, regardless of insurance status, were more likely than whites to have
advanced cancer when first diagnosed.
“The findings of this major study are critical, not only for the 47 million
Americans who have no health insurance, but also for our nation. The fact is, too
many cancer patients are being diagnosed too late, when treatment is harder,
more expensive, and has less chance of saving lives. We must begin to remove
the barriers that stand in the way of early diagnosis and timely access to
medical care if we are to give all cancer patients an equal chance in the
fight,” said John R. Seffrin, Ph.D., chief executive officer for the American
Cancer Society quoted by the Science Daily.
Elizabeth Ward, director of surveillance research for the
Cancer Society explains the way insurance status influences cancer diagnosis. Patients
with insurance are much more likely to have regular screening and physical
examinations.
“If you’re uninsured, you’re about half as likely to get
mammography and colonoscopy as if you’re uninsured,” she said quoted by the
Atlanta Journal Constitution.
The study is published today in the British journal The
Lancet Oncology.