Previous research has indicated some correlation between active Medicaid insurance status and worse outcomes for cancer patients. A team of researchers sought to more closely examine the possible effects that being covered by Medicaid had on patients with head and neck cancer.
Researchers, led by Arash O. Naghavi, MD, of the H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, examined the records of 1698 patients with squamous cell head and neck cancer. None of the patients had distant metastatic disease. Patients comprised 3 insurance status groups: those having Medicaid at the time of diagnosis (11%), those with Medicare or other governmental insurance at the time of diagnosis (34%), and those having private insurance at the time of diagnosis (56%).
Patient overall survival was measured via the Kaplan-Meier method and Cox regression multivariate analysis. Locoregional control was also evaluated for all groups. The Medicaid group was tied to a 26% deficit in overall survival and a 13% deficit in locoregional control. A length of time from diagnosis to start of treatment of more than 44 days was associated with reduced overall survival (68% vs 71%; P =.008) and worse locoregional control (77% vs 83%; P =.009). On multivariate analysis, the patients with Medicaid coverage were found to have longer times between diagnosis and treatment initiation.
The researchers concluded that the greater delay in treatment experienced by patients with Medicaid coverage is a factor in the worse overall survival and locoregional control seen in these patients. Steps taken to speed treatment initiation would be beneficial for this patient subset.
1. Naghavi A, Echevarria M, Grass G, et al. Having Medicaid insurance negatively impacts outcomes in patients with head and neck malignancies. Cancer. 2016 Jul. doi: 10.1002/cncr.30212. [Epub ahead of print]