iStock/Thinkstock(NEW YORK) — The importance of health insurance for cancer patients was again made clear in two new studies, which found those battling two different types of cancers had an increased risk of dying from the disease when they lacked health coverage.
Both studies highlighted how preventative care, which people with health insurance receive more often, can affect overall survival rates for cancer patients. If the disease is caught early, a patient will likely have a far better chance of survival.
“As much as we are making advances in understanding biology and improving treatment for these cancers, early diagnosis and early management is still key, and far more important, as this can cure patients,” Dr. Christopher Sweeney, Senior Physician at the Dana-Farber Cancer Institute and co-author of a study examining how medical coverage affected outcomes among testicular cancer patients told ABC News. “What we can do to improve access to healthcare is a very important part of the strategies we need to implement.”
Researchers at the Dana-Farber/Brigham and Women’s Cancer center looked at 10,211 patients in the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program who had a testicular cancer between 2007-2011, for the first study published in the medical journal Cancer. They focused on patients under 65 and found, of the total patients studied, 10 percent were uninsured and 13 percent had Medicaid insurance.
The researchers saw a pattern: uninsured or Medicaid patients had larger tumors or more advanced disease. They found 44 percent of men with Medicaid, and 44 percent of men without insurance were diagnosed with metastatic disease (stage II or III disease) when the disease was first found. Ultimately, after controlling for variables, they found that men without any insurance had a “26 percent increased risk of being diagnosed with metastatic disease in comparison with men with insurance, and those with Medicaid had a more than 60 percent increased risk.”
These patients also had fewer treatments compared to men who had insurance.
Another study in the same journal showed that 558 brain cancer patients without insurance or with Medicaid insurance also had larger tumors when they got to the doctor, and, not surprisingly, shorter survivals. In this study, researchers from the Department of Neurosurgery at Johns Hopkins University studied a total of 13,665 patients enrolled in the SEER database who were diagnosed with the form of brain cancer called glioblastoma multiforme between 2007 and 2011.
For patients who had insurance, they found that the survival rate each year improved — a 19.6 percent two-year survival rate in 2007 and a 23.9 percent two year survival in 2011. In contrast, no insurance and Medicaid insurance were seen as independent predictors of a shorter survival.
Some patients in these studies who were classified as having Medicaid may have received it after their cancer diagnosis; they may have been “uninsured” at the time of their diagnosis.
The timing of having health coverage could also be important. Even when newly-diagnosed cancer patients were quickly enrolled in Medicaid coverage, it was often after the disease had progressed and worsened their health outcomes before they even received treatment, Dr. Otis Brawley, chief medical officer of the American Cancer Society, said.
“People who have Medicaid, who have cancer, overwhelmingly get Medicaid within a week of being diagnosed,” he said. “They don’t have Medicaid when they need the preventative health, they don’t have it when they have the early symptoms of cancer.”
Brawley pointed out that the studies ended before the Affordable Care Act (ACA), which requires Americans to have health insurance or face a fine, was in place. An increase in the amount of people who have insurance could change the treatment plan for those with cancer.
“When they have early symptoms and might be able to go to the doctor…with early disease, rather than when they are so catastrophic that they have to go to the emergency room,” patients fare better, he said.
Aside from finding new cures for cancer, scientists and medical professionals “need to do research on how to get the treatments that already exist to the patients that need them,” Brawley said.
Brawley said he hoped the findings would spur the public to demand more help getting health coverage.
“I wish society would listen to these results,” he said, noting that action was also needed to help patients get coverage before catastrophic diagnoses. “We don’t need more studies to show a lack of health insurance means that you have lack of health care and lack of health care, including preventative health care, (and that it) means that you die sooner and die in greater distress.”
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