According to research presented at the 2016 Multidisciplinary Head and Neck Cancer Symposium, uninsured patients and patients with Medicaid are more likely to present with advanced stages of head and neck cancer and have higher overall and cancer-specific mortality rates, compared to patients with non-Medicaid insurance.
Drawing on the National Cancer Institute's Survival, Epidemiology and End Results database, researchers examined clinical, demographic and socioeconomic variables in the records of all 53,848 patients diagnosed with primary squamous cell carcinoma of the oral cavity, pharynx or larynx between 2007 and 2012. Patients were divided into three cohorts based on health insurance status:
- Non-Medicaid insurance (80.1 percent)
- Medicaid (15 percent)
- Uninsured (4.9 percent)
Here are three points:
1. Head and neck patients with and without insurance differed significantly from each other in terms of disease stage at time of diagnosis, treatment practices and survival rates.
2. Uninsured and Medicaid patients, compared to insured patients, were more likely to present with American Joint Committee on Cancer Stage III or IV disease (75.1 percent uninsured, 72.9 percent Medicaid, 60.1 percent insured).
3. Rates of both overall mortality and cause-specific mortality were higher for uninsured and Medicaid patients. Odds ratio for uninsured and Medicaid patients, respectively, were 1.48 and 1.55 for overall mortality and 1.65 and 1.60 for cause-specific mortality, compared to those for patients with insurance.