Study finds improvements in cancer survival for privately insured and medicare patients, but not others.

Abstract

Recent improvements in cancer survival were almost exclusively limited to those patients with private or Medicare insurance, whereas survival in those with public or no insurance has been largely unchanged, according to a study published in JAMA Oncology.1 The study, led by researchers at the Cancer Prevention Institute of California in Fremont, examined 1,140,891 patients diagnosed with the 5 most common cancers in California from 1997 to 2014 and estimated 5-year survival in 3 time periods using California Cancer Registry data. The 5 cancers were melanoma, breast cancer, prostate cancer, colorectal cancer, and lung cancer. The researchers state that to their knowledge, their work is the fi rst to examine cancer survival by type of health insurance over time for several diff erent cancers. The results indicated that cancer mortality was signifi cantly higher in uninsured patients compared with privately insured patients for all cancers except that of the prostate. It also was signifi cantly higher for patients with public insurance compared with the privately insured for all cancers except lung cancer. Patients with public insurance such as Medicaid had higher survival rates compared with those with no insurance for breast, prostate, and lung cancer, but having public insurance appeared to have little or no benefi t for those with colorectal cancer or melanoma. Lead author Libby Ellis, PhD, of the Cancer Prevention Institute of California, notes that a lack of access to preventive health care likely plays a major role in these survival disparities, particularly in patients with breast and colorectal cancer, both of which have established screening practices. The authors add that reducing these disparities will require better patient access to health insurance that covers all the necessary elements of health care, including prevention and early detection, timely treatment, and longterm follow-up.