Originally published Monday, February 18, 2008 at 12:00 AM
Privately insured diagnosed sooner
A nationwide study has found that the uninsured and those covered by Medicaid are more likely than those with private insurance to receive...
The New York Times
ATLANTA — A nationwide study has found that the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in the late stages of the disease, often diminishing their chances of survival.
The study by researchers with the American Cancer Society also found that blacks had a higher risk of late diagnosis, even after accounting for their disproportionately high rates of being uninsured. The authors speculated that the disparity might be caused by a lack of health literacy and a shortage of providers in minority communities.
The study is to be published online today in The Lancet Oncology.
Previous studies have shown a correlation between insurance status and the stage of diagnosis for particular cancers. The new research is the first to examine a dozen major cancer types and to do so nationally with the most current data. It mined the National Cancer Data Base to analyze 3.7 million patients who received diagnoses from 1998 to 2004.
The widest disparities were noted in cancers that could be detected early through standard screening or assessment of symptoms, such as breast cancer, lung cancer, colon cancer and melanoma. For each, uninsured patients were two to three times more likely to be diagnosed in Stage III or Stage IV rather than Stage I.
Smaller disparities were found for bladder cancer, kidney cancer, prostate cancer, thyroid cancer, non-Hodgkins lymphoma, uterine cancer, ovarian cancer and pancreatic cancer; only for the last two were the disparities not statistically significant.
When comparing blacks with whites, the disparities in late-stage diagnosis were statistically significant for 10 of the 12 cancers. Hispanics had a higher relative risk as well, but less so than blacks.
The authors concluded that those without private insurance are not receiving the best screening, timely diagnosis or follow-up. Advanced-stage diagnosis, they wrote, "leads to increased morbidity, decreased quality of life and survival and, often, increased costs."
"There's evidence that not having insurance increases suffering," said Dr. Otis Brawley, the American Cancer Society's chief medical officer. He said some patients with possible cancer symptoms were delaying doctor's visits because they were uninsured.
Not all cancer researchers believe that comprehensive screening and early detection is universally constructive. They argue that with certain cancers it can lead to misdiagnosis and overdiagnosis.
Copyright © 2008 The Seattle Times Company
NEW - 11:28 PM
Obama puts heat on Senate to speed health bill
Fitting public policy into push for fitness
Sole Republican to vote for bill knows price
The day The Wall finally came down
NEW - 10:31 PM
Imam: Mosque not linked to hijackers

Mourners gather at KeyArena for slain officer's memorial
Mourners gathered at KeyArena for the memorial service of Seattle police Officer Timothy Brenton on November 6, 2009.
nwjobs

Post a comment

Michelle Goodman blogs about work/life balance.
How to tell your office you're gravely ill
Post a comment
nwautos

Choosing a new sedan? Weigh the impact of your choice on your wallet and on the planet.
Post a comment
- Flags were key link to cop slaying, bombings
- Suspect shot as city mourns slain officer
- Bombs, guns found at home of suspect in Officer Brenton's slaying
- Briefs | Soccer: New Mexico suspends hair-pulling player Elizabeth Lambert
- How an underdog named Mike McGinn took City Hall
- 3 Cascade Mountain passes close due to snow; more rain, wind expected Sunday
- Huskies suffer another heartbreaking loss to UCLA
- The birth of 'Grunge,' in photos by Michael Lavine
- McGinn pulling away as late ballots come in
- Using anti-shooter tactics, civilian Army police officer brought down gunman
- U.S. House passes health plan
378 - Bombs, guns found at home of suspect in Officer Brenton's slaying
299 - Grading the game
161 - Referendum 71 show's Washington's strategy for marriage equality is working
161 - Beavers open as 10-point favorites against Huskies
95 - How an underdog named Mike McGinn took City Hall
94 - Sounders FC-Dynamo playoff Game 2 thread
81 - Fort Hood shooting suspect had shown troubling signs
75 - Game thread: Detroit Lions at Seattle Seahawks, Nov. 8
74 - Landmark health bill passes House on close vote
72
- Suspect shot as city mourns slain officer
- Flags were key link to cop slaying, bombings
- The birth of 'Grunge,' in photos by Michael Lavine
- Bombs, guns found at home of suspect in Officer Brenton's slaying
- 10 ways to take control of your health
- Tlingit heritage helps glass artist Preston Singletary break new ground
- 10 investing missteps to avoid
- How an underdog named Mike McGinn took City Hall
- How do innovators think?
- Danny Westneat | Lee the Horse Logger found slow wagon shrank tumor





