Insurance Status Could Affect Cancer Survival

Uninsured or Medicaid insured patients were more likely to have worse outcomes.

New studies have shown that health insurance could potentially affect health outcomes of patients with cancer.

In the 2 studies, both published in Cancer, researchers found that uninsured patients or Medicaid beneficiaries were diagnosed later, received less optimal treatment, and had shorter survival compared with patients with alternative insurance. Researchers used data from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.

In the study that examined insurance status and testicular cancer, researchers included 10,211 men diagnosed between 2007 and 2011. Patients who were uninsured, or were insured through Medicaid, had an increased risk of larger tumors or metastatic cancer compared to men with alternative coverage.

This population were also more likely to die from testicular cancer. These patients also had an “intermediate” or “poor” risk, opposed to a “good” risk if they had metastatic disease, according to the study.

Uninsured and Medicaid insured patients were also not as likely to receive potentially curative surgery in early stages compared with patients with other insurance. Uninsured patients were also less likely to receive radiation in more advanced disease stages.

“Although testis cancer is curable with chemotherapy, this study supports the notion that lack of insurance may lead to delays in diagnosis and more advanced and less curable disease,” said lead researcher Christopher Sweeney, MBBS. “Our findings support the belief that early diagnosis and management is key, and removal of barriers to access to health care should be implemented.”

In the second study, researchers included 13,665 patients diagnosed with glioblastoma between 2007 and 2012. Researchers found that insured patients who were not Medicaid-insured had an improved survival over time.

“This suggests that while improvements in medical therapy have resulted in longer survival, this benefit is less likely to be accessible to Medicaid-insured or uninsured patients," said lead author Judy Huang, MD.

Researchers found that patients who were not insured, or were insured through Medicaid, were more likely to have larger tumors and die sooner compared with patients with other insurance.

Medicaid beneficiaries were less likely to receive surgery. These patients, along with uninsured patients, were also less likely to receive adjuvant radiotherapy, according to the study.

"This study indicates significant disparities in the management of glioblastoma patients under our existing healthcare insurance framework that need to be addressed," said co-lead author of the study Wuyang Yang, MD, MS.