Insurance Status Influences Stage at Diagnosis of Breast and Oropharyngeal C.
According to the results of two studies published in the journal Cancer, patients who have no health insurance or limited health insurance tend to be diagnosed with more advanced stages of breast and oropharyngeal cancer.
An estimated 20% of Americans under the age of 65 lack health insurance and many others have only limited insurance. A lack of health insurance has been linked with less access to preventive care, less timely receipt of care, and a lower likelihood of receiving recommended treatments.
Two recent studies built upon these findings by exploring the relationship between insurance status and stage at cancer diagnosis. The types of cancer evaluated by these studies-breast and oropharyngeal (a type of head and neck cancer)-are quite treatable when caught early. Early detection, however, requires access to screening and follow-up as well as timely and appropriate evaluation of symptoms.
Researchers involved in the breast cancer study looked at more than 500,000 women over the age of 40 years who were reported to the National Cancer Data Base between 1998 and 2003. They reported that the proportion of women with advanced breast cancer (Stage III or Stage IV) at the time of diagnosis was 8% among privately insured women, 18% among uninsured women, and 19% among women being treated on Medicaid. Uninsured women and women on Medicaid were significantly less likely to have Stage I breast cancer than privately insured women.
Researchers involved with the oropharyngeal study looked at over 40,000 individuals who were reported to the National Cancer Data Base between 1996 and 2003. They reported that uninsured patients and patients on Medicaid were roughly 30% more likely to be diagnosed with advanced disease than privately insured patients.
The results confirm that lack of adequate health insurance can have important adverse effects on health. In an accompanying editorial, Dr. Richard Wender of the American Cancer Society and Thomas Jefferson University writes “Clearly, the issues of adequacy, availability, and affordability of coverage are serious problems that must be addressed collectively as we work to fix what is wrong with our health care system.”
 Halpern MT, Bian J, Ward EM, et al. Insurance status and stage of cancer at diagnosis among women with breast cancer. Cancer. 2007;110: 403-411.
 Chen AY, Schrag NM, Halpern MT, et al. The impact of health insurance status on stage at diagnosis of oropharyngeal cancer. Cancer. 2007;110:396-402.
[3 Wender RC. The adequacy of the access-to-care debate: looking through the cancer lens. Cancer. 2007;110:231-233.