Health insurance coverage among cancer patients varies greatly by demographics and cancer type

A new analysis has found that, among patients with cancer, rates of health insurance coverage vary by patient demographics and by cancer type. The findings suggest that the expansion of coverage through the Affordable Care Act may disproportionally benefit certain patient populations (Cancer. 2015; doi:10.1002/cncr.29120).

In the United States, an estimated 48 million people 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 whose diagnosis was one of the top 25 cancers and was made 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 a 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.

"To our knowledge, this is the first study that looks at variation in insurance status according to type of cancer," said Mahmood. "Both insurance status and type of cancer are affected by demographic factors, and it was interesting to see how each varies with the other."

Mahmood added that the study provides insights into which subsets of cancer patients will likely benefit the most from the expansion of health care coverage under the Affordable Care Act. "Further research will be required to determine how changes in health care coverage impact the presentation, treatment, and survival of cancer patients," he said.

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