Using population-based data from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, two new studies looked at testicular germ cell tumors and glioblastoma and found that only private insurance had better outcomes for patients.
Those on Medicaid and with no insurance at all fared poorly by comparison. In the testicular cancer study, researchers identified 10,211 men diagnosed with testicular cancer, a disease highly curable with chemotherapy if caught early enough, between 2007 and 2011. Government insurance patients and the uninsured both had an increased risk of having larger testicular cancer tumors or metastatic disease at the time of diagnosis, and they were more likely to die from their disease compared to men with private insurance.
Among patients with metastatic disease, those who were uninsured or had Medicaid coverage were more likely to have cancer categorized as “intermediate” or “poor” (rather than “good”) risk. Among patients with early stage disease, both uninsured and Medicaid patients were less likely to have lymph nodes removed, a procedure that can cure some patients. Among patients with advanced disease, uninsured patients were less likely to receive radiation therapy.
Glioblastoma is the most common malignant primary brain tumor in adults. In that study, the researchers examined data on 13,665 patients diagnosed between 2007 and 2012. Patients who were uninsured or had government health insurance were more likely to present with larger tumors and to die earlier from their disease compared with insured patients.
Patients with Medicaid insurance were less likely to receive surgical treatment, while both Medicaid insurance and uninsured status were associated with a lower likelihood of receiving adjuvant radiotherapy. Only patients with private insurance experienced an improvement in survival over time, with patients diagnosed in 2012 living longer than those diagnosed in 2007. Clearly medical therapy has improved, but the uninsured or those with government health insurance were less likely to benefit from the improvements.
References: Sarah C. Markt, Carlos A. Lago-Hernandez, Rowan E. Miller, Brandon Mahal, Brandon Bernard, Laurence Albiges, Lindsay Frazier, Clair Beard, Alexi A. Wright, and Christopher J. Sweeney, “Insurance Status and Disparities in Disease Presentation, Treatment and Outcomes in Men with Germ Cell Tumors”, CANCER, August 8, 2016 DOI: 10.1002/cncr.30159 Xiaoming Rong, Wuyang Yang, Tomas Garzon-Muvdi, Justin M. Caplan Xuan Hui, Michael Lim, and Judy Huang, “Influence of Insurance Status on Survival of Adults with Glioblastoma (GBM): A Population Based Study”, CANCER, August 8, 2016 DOI: 10.1002/cncr.30160