The study, in the January/February issue of CA: A Cancer Journal for Clinicians, used data from the National Cancer Database, which is the only national registry that collects data on patient insurance.
The report is an overview of systems of health insurance in the United States. It has data on the association between health insurance, screening, stage at diagnosis, and survival for breast and colorectal cancer.
The link between access to care and cancer outcomes is particularly striking for cancers that can be prevented or found early by screening and for which there are effective treatments, including breast and colorectal cancer.
Only about 38.1 percent of uninsured women aged 40 to 64 have had a mammogram in the past two years, compared with 74.5 percent of insured women. In addition, 20 percent to 30 percent of uninsured women are diagnosed with late-stage breast cancer, compared with 10 percent to 15 percent of women with private insurance, according to the study.
Uninsured women are less likely to be diagnosed with early breast cancer than women who are privately insured. This disparity was greatest among white women, where almost 50 percent of those with private insurance were diagnosed with early-stage cancer, compared with fewer than 35 percent of uninsured white women.
Moreover, 89 percent of insured white women were living five years after breast cancer diagnosis compared with 76 percent of uninsured white women. For black women, five-year survival rates are 81 percent for those with private insurance and 65 percent for uninsured women.
For men and women aged 50 to 64 who have private insurance, 48.3 percent were screened for colorectal cancer in the past 10 years compared with fewer than 18.8 percent of the uninsured.
In addition, uninsured patients are more likely than those with private i
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