Medicaid Beneficiaries, Uninsured Patients Have Higher-Risk, Less Treated Prostate Cancer

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Medicaid coverage and uninsured status were independent predictors of higher-risk prostate cancer and lack of local treatment.
Medicaid coverage and uninsured status were independent predictors of higher-risk prostate cancer and lack of local treatment.

Medicaid beneficiaries and uninsured patients with prostate cancer are diagnosed with higher-risk disease and are undertreated when compared with insured patients, a new study has found.1 Treatment disparities are accentuated for uninsured patients with high-risk disease and may “seriously compromise” their survival, the study found.

“Access to care is a significant problem in our country,” said study coauthor Quoc-Dien Trinh, MD, of Brigham and Women's Hospital, Harvard Medical School, Boston, MA, in an email to Cancer Therapy Advisor.

“Americans are 4 times more likely to not seek care for a medical problem for financial reasons compared to any other country in the Western world.”

Researchers identified 20 393 patients younger than 65 years with prostate cancer in the 2010-2011 Surveillance, Epidemiology, and End Results database.

They analyzed the relationship between insurance status and 2 endpoints: presenting with low-risk prostate cancer at diagnosis, and receiving local prostate treatment. Medicaid coverage and uninsured status were found to be independent predictors of an increased incidence of presenting with higher-risk disease and a lower probability of receiving local treatment. Treatment disparities were twice as high for high-risk patients than for low-risk patients.

Dr Trinh noted that this has serious consequences for patients with prostate cancer and may include missed opportunities to cure the disease. “This has long-term implications as metastatic prostate cancer impedes a patient's quality of life,” he said.

RELATED: Initial Gleason Score Does Not Impact Abiraterone Benefit in Prostate Cancer

Yousuf Zafar, MD, MHS, of Duke University School of Medicine in Durham, NC, has conducted multiple studies on how treatment-related costs impact cancer patients' experience.

“Many studies have suggested an association between lower socioeconomic status and worse cancer-related outcomes,” he told Cancer Therapy Advisor via email. “There are multiple factors at play here, with insurance being only one of them. It is possible that insurance status is a proxy measure for poor access to health care.”

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