by Steven Reinberg, HealthDay Reporter
People who either have no health insurance or rely on Medicaid are more likely to be diagnosed with advanced cancers than people who have private health insurance, researchers from the American Cancer Society report.
At a time when more than 47 million Americans have no health insurance, the new study clearly shows the effect health insurance has on the timely diagnosis of cancer.
This finding follows an earlier study from the American Cancer Society that showed uninsured patients with cancer were 60 percent more likely to die than insured cancer patients.
"Having financial barriers to health care, based on insurance status, is having a significant impact on our efforts to reduce the toll of cancer," said Elizabeth Ward, director of surveillance research in the department of epidemiology and surveillance research at the American Cancer Society.
"We could make considerable progress in reducing cancer mortality if we could ensure that financial barriers, such as lack of health insurance, did not prevent people from getting recommended cancer screening and access to health care when they have symptoms," Ward added.
In the study, Ward's team used the National Cancer Database, which includes data from 1,430 medical facilities and information on 73 percent of cancer patients in the United States. The current study looked at patients aged 18 to 99 who were diagnosed with any of 12 cancers between 1998 and 2004.
There was a consistent relationship between insurance coverage and the stage at which cancer was diagnosed. Uninsured patients were significantly more likely to be diagnosed with advanced cancers compared with patients who were privately insured, the researchers found.
The two cancers that were most likely to be diagnosed in advanced stages among the uninsured were colorectal cancer and breast cancer.
In addition, Medicaid patients also had an increased risk of being diagnosed with advanced cancer, Ward's group found.
For both Medicaid patients and uninsured patients, cancers that are routinely screened for were the most likely to be diagnosed in an advanced stage. This was also true for cancers that present with symptoms in the earliest stages, such as melanoma and bladder cancer.
Cancers such as pancreatic and ovarian cancer tended to be diagnosed in later stages, regardless of whether the patient was insured, uninsured or on Medicaid. These cancers are typically found in an advanced stage since there are no screening tests that could find them early, Ward noted.
In addition, blacks were more likely to be diagnosed with advanced cancers. This finding shows that barriers to screening tests and health care beyond insurance negatively affect black patients, the researchers suggest.
The American Cancer Society thinks that the health-care system in the United States needs to be reformed, Ward said. "There needs to be a process of really looking at the problems with the way the health insurance system is working. There needs to be a dialogue about how to make this better," she said.
References
Reinberg S. Timely Cancer Diagnosis Linked to Insurance Status. HealthDay News; 18 February 2008.
Halpern M, Ward E, Payluck A et al. Association of insurance status and ethnicity with cancer stage at diagnosis for 12 cancer sites: a retrospective analysis. Lancet Oncology DOI:10.1016/S1470-2045(08)70032-9; 18 February 2008.
