Published early online in Cancer, the findings suggest that the expansion of coverage through the Affordable Care Act may disproportionally benefit certain patient populations.
In the United States, an estimated 48 million individuals live without health insurance. To examine how insurance coverage differs among cancer patients according to various individual factors such as age, gender, and race, as well as according to different cancer types, Usama Mahmood, MD, an investigator at the University of Texas MD Anderson Cancer Center in Houston, and Stephen Grant, a medical student at Baylor College of Medicine, led a team that analyzed information from the Surveillance, Epidemiology, and End Results (SEER) database, which compiles incidence and survival data from population-based cancer registries in the United States. Their analysis included 688,794 patients age 18 to 64 years who were diagnosed with one of the top 25 cancers between 2007 and 2010.
The researchers found that younger, non-White, unmarried patients residing in counties with higher levels of poverty and in rural areas were less likely to have insurance. Moreover, males were less likely to have insurance than females, and people residing in Southern states were less likely to have insurance than people residing in other areas of the country. Also, there was large variation in insurance rates by cancer type, with the highest uninsured rates in testicular, stomach, and cervical cancers, and the lowest uninsured rates in thyroid, prostate, and breast cancers. Among all uninsured patients, however, the most prevalent cancers were lung cancer (which also resulted in the greatest number of cancer deaths), colorectal cancer, and breast cancer.
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