Insurance status linked to cancer outcomes

December 20, 2007

ATLANTA - December 20, 2008- A new report from the American Cancer Society finds substantial evidence that lack of adequate health insurance coverage is associated with less access to care and poorer outcomes for cancer patients. The report finds the uninsured are less likely to receive recommended cancer screening tests, are more likely to be diagnosed with later stage disease, and have lower survival rates than those with private insurance for several cancers. The new findings on stage at diagnosis and survival by insurance status use data from the National Cancer Database (NCDB), a hospital-based registry sponsored by the American College of Surgeons and the American Cancer Society, the only national registry that collects information on patient insurance status. The report appears in the January/February issue of CA: A Cancer Journal for Clinicians, a peer-reviewed journal of the American Cancer Society.

In 2007, the American Cancer Society launched a nationwide campaign to highlight the role of access to quality care for all Americans. While advances in the prevention, early detection, and treatment of cancer have resulted in an almost 14 percent drop in the death rates from all cancers combined from 1991 to 2004 in the U.S., with remarkable declines in mortality for the top three causes of cancer death in men (lung, colorectal, and prostate cancer) and two of the top three cancers in women, (breast and colorectal cancer), not all segments of the population have benefited equally from this progress. Evidence suggests that some of these differences are related to lack of access to health care. In particular, the lack of health insurance, or inadequate health insurance, appears to be a critical barrier to receipt of appropriate health care services. The report provides an overview of systems of health insurance in the United States and presents data on the association between health insurance status and screening, stage at diagnosis, and survival for breast and colorectal cancer based on analyses of the National Health Interview Survey (NHIS) and the NCDB. Among the report's findings: For breast cancer, the article reports that: For colorectal cancer, the report found that: Other findings from the study: "As our nation's investments in cancer research provide greater understanding of how to prevent cancer, detect it early, and treat it effectively, access to health care becomes even more important to the American Cancer Society's goal of eliminating cancer as a major public health problem," said Otis Brawley, M.D., chief medical officer of the American Cancer Society. "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."

"These findings put insurance status squarely on the table as an important factor in cancer care disparities," said Elizabeth Ward, Ph.D., director of surveillance research and co-author of the report. "It's important to note that although variations in health insurance coverage likely contribute to racial and ethnic disparities in cancer outcomes, those disparities persist for several outcomes even when differences in insurance status are accounted for. So even if health insurance and financial barriers can be overcome, further research and interventions will be needed to address these other barriers."

"The truth is that there are gaping holes in our health care safety net and that most of these safety-net services are neither effective nor efficient in providing chronic-disease prevention, detection, or treatment," writes Elmer Huerta, M.D., American Cancer Society president, in an accompanying editorial. "The truth is that our national reluctance to face these facts is condemning thousands of people to die from cancer each year and thousands more to die of other diseases," adding that "[f]or 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."
-end-
Article: "Association on Insurance with Cancer Care Utilization and Outcomes," , E Ward, M Halpern, N Schrag, V Cokkinides, C DeSantis, P Bandi, R Siegel, A Stewart, A Jemal, CA Cancer J Clin 2008;58:9-31, DOI: 10.3322/CA.2007.0011

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. For more information anytime, call toll free 1-800-ACS-2345 or visit www.cancer.org.

American Cancer Society

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.