Lack Of Health Insurance Leads To Late Cancer Diagnosis
While cancer sufferers in the United States without health insurance are usually able to get treatment eventually, they are significantly more likely than those with private insurance to receive their cancer diagnosis at a more advanced stage of the disease, according to an article by researchers from the American Cancer Society (ACS) that appeared in the March issue of the medical journal The Lancet Oncology.
The article, “Association of insurance status and ethnicity with cancer stage at diagnosis for 12 cancer sites: a retrospective analysis,” was written by a group of researchers led by Michael Halpern, M.D., Ph.D., strategic director of health services research at ACS. The study compared insurance status and stage of diagnosis among cancer patients using the National Cancer Database, a hospital-based registry containing patient information from some 1,430 medical facilities. The analysis included data about adult patients diagnosed with any of 12 cancers between 1998 and 2004.
Compared to patients with private insurance, uninsured patients were found to have significantly increased likelihoods of being diagnosed with cancer at more advanced stages. The greatest risk for being diagnosed with moderately advanced cancer (stage II), instead of at the earliest stage (stage I), was found to be among uninsured colorectal cancer patients. Meanwhile, uninsured breast cancer sufferers faced the highest risk of receiving their first diagnosis at stages III or IV.
The gaps between patients with different insurance statuses were found to be greatest for cancer sites that are part of routine screening, such as breast and colorectal cancer, and cancer types for which symptoms present at early stages, such as melanoma and urinary bladder cancer. On the other hand, the study found no major differences in the chances of being diagnosed with later stages of cancer among forms of the disease for which no screening tests are available, such as ovarian and pancreatic cancers.
The analysis also showed that patients insured through Medicaid faced a higher risk of late diagnosis than patients with private insurance. Researchers noted, however, that many of these Medicaid patients were likely to have been enrolled after diagnosis, and they may have been previously uninsured. Additionally, the study found that African American patients were significantly more likely than other ethnic groups to be diagnosed with cancer at a more advanced stage.
“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,” said John R. Seffrin, Ph.D., chief executive officer for the American Cancer Society. “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.”
