Medicaid and Uninsured Patients More Likely to Present With Advanced Disease

Patients with Medicaid insurance and those without insurance were more likely to present with distant disease than patients with private insurance, according to results presented in the Journal of Clinical Oncology.

Gary V. Walker, MD, MPH, in the department of radiation oncology at the University of Texas MD Anderson Cancer Center and colleagues determined the association of insurance status with disease stage at presentation, treatment, and survival among the top 10 most deadly cancers using the SEER (Surveillance, Epidemiology, and End Results) database of the National Cancer Institute.

A total of 473,722 patients between the age of 18 and 64 who were diagnosed with one of the 10 most deadly cancers in the SEER database from 2007 to 2010 were analyzed.

Overall, patients with non-Medicaid insurance were less likely to present with distant disease (16.9%) than those with Medicaid coverage (29.1%) or without insurance coverage (34.7%). Patients with non-Medicaid insurance were more likely to receive cancer-directed surgery and/or radiation therapy (79.6%) compared with those with Medicaid coverage (67.9%) or without insurance coverage (62.1%).

When the findings were adjusted for age, race, sex, marital status, poverty level, tumor site and stage, patients were more likely to die as a result of their disease if they had Medicaid coverage or no insurance compared with non-Medicaid insurance.

Source:

Walker GV, Grant SR, Guadagnolo BA, Hoffman KE, Smith BD, et al. Disparities in stage at diagnosis, treatment, and survival in nonelderly adult patients with cancer according to insurance status. J Clin Oncol. 2014 Aug 4. pii: JCO.2014.55.6258. [Epub ahead of print].