Large Study Finds Improvements in Cancer Survival For Patients With Private Insurance Or Medicare But Not For Those With No or Public Insurance

Study compares survival for the five most common cancers diagnosed from 1997–2014 by health insurance status.   

FREMONT, CA (November 30, 2017) — There have been substantial improvements in the early detection, treatment and survival from cancer in the United States, but it is not clear to what extent patients with different types of health insurance have benefitted from these advancements.

In a study published today in JAMA Oncology, researchers found improvements in survival were almost exclusively limited to patients with private or Medicare insurance. For patients with other public or no insurance, survival was largely unchanged or declined. 

The five most common cancers diagnosed in California are melanoma, breast, prostate, colorectal, and lung cancer. To conduct this study researchers examined 1,149,891 patients diagnosed with these cancers from 1997-2014, and estimated five-year survival in three time periods using California Cancer Registry data. 

To the researchers’ knowledge, this is the first study to examine cancer survival by type of health insurance over time, for a number of different cancers.

Cancer mortality was significantly higher in uninsured patients than privately insured patients for all cancers except prostate. Mortality was also found to be significantly higher for patients with public insurance compared to those with private insurance for all cancers except lung.  

Researchers found that while survival falls short of that achieved by patients with private insurance, patients with public insurance such as Medicaid had higher survival than those with no insurance for breast, prostate and lung cancer. However, there was little or no benefit of public insurance over no insurance for colorectal cancer or melanoma.

According to Libby Ellis, the lead researcher of the study, “A lack of access to preventative health care is likely to have played a key role in these survival disparities, especially for breast and colorectal cancer, for which established screening practices exist."

Patients with public or no insurance may also face difficulties accessing high-quality cancer care. To address these disparities in cancer survival, patients need access to health insurance that covers all the necessary elements of health care, from prevention and early detection, through to timely treatment and long-term follow-up. 

Other researchers who participated in this study are Alison J. Canchola from the Cancer Prevention Institute of California, David Spiegel and Uri Ladabaum from Stanford, Robert Haile from Cedars-Sinai Medical Center and Scarlett Lin Gomez from the Cancer Prevention Institute of California and UCSF.

This work was supported by a 2016 Translational Research Award from the Stanford Cancer Institute, and by the National Cancer Institute’s Surveillance, Epidemiology and End Results Program awarded to the Cancer Prevention Institute of California.

About the Cancer Prevention Institute of California
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