The lack of private health insurance affected cancer survival
MIAMI – The lack of private health insurance and the related lack of access to health care appear to affect mortality in patients with cancer of the uterus and may partly explain the difference in mortality between African Americans and other ethnic groups, according to data at the Third presented conference of the AACR Science of Cancer health disparities.
“Are die Afro-Americans twice as often within four years compared adjusted to white patients for age, installation and education. However, if insurance, treatment and clinical factors, this probability decreased later to 30 percent,” said Dana Chase, MD, clinical investigator at the University of California, Irvine.
Chase and his colleagues presented a retrospective analysis of 178 891 patients in the national database of cancer. Whites accounted for about 74 percent of the cohort, while Hispanics were made by 5 percent and 9 percent African American. The remaining patients had no particular racial data.
The unadjusted survival rates of four years were 80.7 percent among the uninsured, 75.93 percent for Medicaid insurance, 79.45 percent for younger Medicare patients, 69 35 percent for Medicare patients and 88.93 percent for privately insured patients.
The unadjusted survival rate for four years with uterine cancer was 82 percent for whites and Hispanics, but only 63 percent for black. Some of the differences in survival of the race was due to the advanced stage of disease at diagnosis. But even taking into account the severity of the disease, African Americans experienced a worse survival rate compared with white patients.
Non-insured patients 1.46 times more likely to die within four years after the adjustment for demographic and clinical factors. Medicaid insured and insured by Medicare in recent years (18 to 64 years) were 1.74 and 2 5 times more likely to die within four years compared to patients with private insurance, respectively. However, the survival pattern in patients younger than Medicaid and Medicare difficult to interpret because the registry retroactive insurance plans as a result of a cancer diagnosis. In addition, in this study included co-morbidity, which can vary by insurance, and contribute to poorer survival outcomes.
“Other variables play a role in access to care for minorities and we need to look further, but it is from this study that the insurance undoubtedly plays a clear role,” said Chase.
source:eurekalert.org