Cancer

Uninsured Americans are less likely to get screened for cancer, more likely to be diagnosed with an advanced stage of the disease, and less likely to survive that diagnosis than their privately insured counterparts, according to a new American Cancer Society report examining the impact of health insurance status on cancer treatment and survival.
The article, posted online today and set to be published in the January-February 2008 issue of CA: A Cancer Journal for Clinicians, the peer-reviewed journal of the American Cancer Society, was authored by American Cancer Society researchers, led by Elizabeth Ward, PhD, managing director, surveillance research.
Previous studies have shown that uninsured and Medicaid patients are more likely to be diagnosed with late-stage cancers, in large part because they can't afford preventive services and cancer screening. This report looks at the relationship between health insurance status and cancer care more closely, weighing demographic and socioeconomic factors as well as race.
"This report clearly suggests that insurance and cost-related barriers to care are critical to address if we want to ensure that all Americans are able to share in the progress we have achieved by having access to high-quality cancer prevention, early detection, and treatment services," said Otis Brawley, MD, chief medical officer of the American Cancer Society, when the report was released.
Many Forego Care
American Cancer Society researchers analyzed 598,635 cases using the most recent data from the National Cancer Data Base (NCDB), a hospital-based registry held by ACS and the Commission on Cancer of the American College of Surgeons. The NCDB tracks approximately 70% of the cancer cases in the United States and collects data from about 1,500 hospitals. The patients included had either private insurance, Medicaid, or no insurance. The researchers also examined data from the 2005 and 2006 National Health Interview Survey (NHIS), a nationwide in-person survey of approximately 40,000 U.S. households conducted by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC).
For all cancers combined, the ACS researchers found that uninsured patients were 1.6 times as likely to die within 5 years compared to individuals with private insurance.
People with lower incomes were less likely to have insurance, the report found. And those without insurance were less likely to use certain health services. About 54% of uninsured patients aged 18 to 64 did not have a usual source of health care. About 26% delayed care due to cost, while nearly 23% did not get care because of cost. An estimated 23% did not get prescription drugs because of the expense.
"For too many hardworking 'average Americans' paying for cancer treatment means not paying rent, mortgage (resulting in foreclosure or eviction), or utility bills, or even going hungry," wrote Elmer Huerta, MD, American Cancer Society president, in an accompanying editorial