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Worse Cancer Diagnosis for Uninsured

Medicaid Recipients, People Lacking Health Insurance Diagnosed With Cancer at Later Stages
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WebMD Health News

Feb. 18, 2008 -- Americans without health insurance and those on Medicaid are diagnosed with cancer at a later, more advanced stage than those with private health insurance, according to a new study.

Many common cancers that are treatable in their early stages, such as breast cancer and colorectal cancer, are much deadlier when diagnosed at an advanced stage. That's why early diagnosis is critical to successful treatment.

Researchers found that the greatest risk of advanced-stage cancer diagnosis involved types of cancer that could have potentially been detected early by routine screening or monitoring for symptoms in the early stages.

Researchers say the findings should have important implications for the nation's health care system and policy decisions about health care reform.

"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," John R. Seffrin, PhD, chief executive officer of the American Cancer Society, says in a news release. "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."

Cancer Diagnosis Linked to Insurance Status

In the study, researchers from the American Cancer Society examined the effect of health insurance status and ethnicity on cancer stage at the time of diagnosis for 12 common types of cancer. The study looked at more than 3.7 million Americans diagnosed with cancer between 1998 and 2004.

The results, published in Lancet Oncology, showed that uninsured and Medicaid-insured people were significantly more likely to be diagnosed with cancer at a later stage than those with private health insurance.

For example, the odds of being diagnosed with stage III or stage IV colorectal cancer were two times and 1.6 times greater, respectively, among the uninsured and those on Medicaid than those with private health insurance. For advanced melanoma (the deadliest form of skin cancer), the odds were 2.3 times and 3.3 times greater for uninsured and Medicaid-insured patients.

African-Americans and Hispanics were also more likely to be diagnosed with advanced cancer, regardless of their health insurance status, than whites.

"The findings from our analysis, in terms of Medicaid, suggest that simply providing health insurance without ensuring that this coverage is sufficient is unlikely to substantially increase the proportion of patients diagnosed at early stages," write researcher Michael Halpern, MD, of the American Cancer Society, and colleagues. "Changes in insurance coverage for the uninsured and underinsured need to consider the adequacy, availability, and affordability of new programs."

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