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Medicaid News
Medicaid, Uninsured Patients More Likely to Be
Diagnosed with Advanced Cancer
Study by American Cancer Society included 3.5 million
patients
 Feb. 20, 2008 - A new American Cancer Society study
of twelve types of cancer among more than 3.5 million cancer patients
finds uninsured patients were significantly more likely to be found with
advanced stage cancer compared to patients with private insurance.
Medicaid patients, too, for many cancers, had significantly increased
risks of developing more advanced stages before the cancer was
discovered.
Even more disturbing, the study finds the strongest
association between insurance status and advanced cancer was for cancers
that can be detected early by screening or evaluation of symptoms.
The study, which appears in the March issue of The
Lancet Oncology, is the first to use national data to investigate
insurance status and stage of diagnosis for a large number of cancer
sites
For their study, American Cancer Society
researchers led by Michael Halpern, M.D., Ph.D., strategic director of
health services research, compared insurance status and stage at
diagnosis using the National Cancer Database, a hospital-based registry
capturing patient information from approximately 1,430 facilities. The
database includes information for approximately 73 percent of patients
diagnosed with cancer in the U.S. The new analysis included patients in
the database between ages 18 and 99 diagnosed with any of 12 cancers
between 1998 and 2004.
The study found consistent associations between
insurance status and stage at diagnosis across multiple cancer sites.
Compared to patients with private insurance, uninsured patients had
significantly increased likelihoods of being diagnosed with cancer at
more advanced stages.
The greatest risk for diagnosis at with moderately
advanced cancer (stage II) instead of the earliest stage (stage I) was
in colorectal cancer, while the highest risk for diagnosis at the most
advanced stage of cancer (stage III/IV) was in breast cancer.
The greatest increase in risk of more advanced
stage diagnosis among both uninsured and Medicaid-insured occurred for
cancer sites that are part of routine screening (e.g., breast,
colorectal) or sites with symptoms present at early stages (melanoma,
urinary bladder).
In contrast, the likelihood of diagnosis at more
advanced stages for pancreas or ovary cancer, while higher, was not
significant or only marginally significant for uninsured and Medicaid
patients compared to privately insured patients. These two sites
characteristically present with advanced stage at diagnosis and do not
have screening tests or specific symptoms to allow doctors to diagnose
them at an early stage.
The authors note that some of the patients who were
coded as having Medicaid insurance were likely to have been enrolled
after diagnosis, and thus their later stage at diagnosis may not reflect
ability to obtain cancer screening and timely diagnosis among
individuals with Medicaid coverage but instead, barriers to medical care
due to lack of health insurance.
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Cancer Death Rates Continue Decline but at Lower
Rate Causing Deaths to Jump
 Half million cancer deaths have been avoided says
American Cancer Society report
Feb. 20, 2008 There is good news and there is bad
news in the latest statistics on cancer in the United States. The bad
news - there was an increase of 5,424 deaths (559,312 in
2005 compared to 553,888 in 2004). The good news The
cancer death rate continues to decline and has decreased by 18.4%
among men and by 10.5% among women since the decline in rates began in the early 1990s. This means 534,500 fewer
deaths, according to the
report by the American Cancer Society.
Read more...
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The study also found African American patients were
significantly more likely to be diagnosed at a more advanced stage
diagnosis for many cancers, indicating that beyond the effects of health
insurance, other barriers likely exist for Black patients related to
early diagnosis and prompt medical care.
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.
Editors Notes:
Article: Association of insurance status and
ethnicity with cancer stage at diagnosis for 12 cancer sites: a
retrospective analysis, MT Halpern, EM Ward, AL Pavluck, NM Schrag, J
Bian, AY Chen, Lancet Oncology, March 2008
The American Cancer Society is dedicated to
eliminating cancer as a major health problem by saving lives,
diminishing suffering and preventing cancer through research, education,
advocacy and service. Founded in 1913 and with national headquarters in
Atlanta, the Society has 13 regional Divisions and local offices in
3,400 communities, involving millions of volunteers across the United
States.
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