Retrospective study of impact of race and health care insurance on stage at presentation of common cancer at a rural university hospital over a 10 years period—1996 to 2005

Abstract

17537 Background: Minorities tend to seek treatment when their cancer is in more advanced stage. This retrospective study is to see the impact of race and health care insurance on stage at presentation of common cancer at a rural university hospital Methods: Data from patients with breast, lung, colorectal and head neck cancer, treated from 1996 to 2005 at a rural university hospital were collected from the cancer registry data bank. Breast, colorectal, lung, and head/neck cancer were chosen because of increase frequency of these cancers, and also early diagnosis of these cancers could lead to cure. Patients were analyzed for their ethnicity, insurance type, and stage of cancer at diagnosis. Cancer stages 0 to 2 were considered early stage where as cancer stage 3 to 4 were considered late stage. Health care insurances were classified as not insured, private insurance, medicaid, medicare and unknown. The null hypothesis and the alternative hypothesis were used for statistical analysis. The chi square test for independence using a contingency table was performed. Results: Of the 1698 patients studied, 551 had breast cancer, 609 had lung cancer, 377 had colorectal cancer and 161 had head/neck cancer. 525 patients with breast cancer, 609 with lung cancer, 347 patients with colorectal and 148 patients with head/neck cancer could be analyzed. At a significance level of 0.05, we can conclude that for breast cancer the type of insurance patient had and the stage of cancer at presentation are related. This was not true for lung cancer, colorectal cancer, and head/neck cancer. With regards to relationship between type of insurance and ethnic type at a significance level of 0.05, type of insurance patients had and ethnic type are related only for breast cancer and lung cancer and not for head/neck cancer. For colorectal cancer the type of insurance patients have and ethnic type were related only at a significance level of 0.1. Conclusion: Minority patients like Hispanics and African Americans having breast and lung cancer are more likely to have no insurance and hence present at a later stage. Future focus should be on these individual for early detection of cancer especially breast and lung cancer which are curable at an early stage. No significant financial relationships to disclose.