Women with gynecologic cancer age 65 or older who are dually enrolled in Medicare and Medicaid have a 34% increased risk of all-cause mortality after diagnosis compared to women in the Medicare population who are not dually enrolled, according to a recent study published online ahead of print in Cancer.

In a local population-based cohort study, Kemi Doll, MD, and fellow researchers from the University of North Carolina at Chapel Hill examined 4,522 women 65 or older — 3,702 enrolled in Medicare and 820 dually-enrolled – who were diagnosed with some form of gynecologic cancer from 2003 to 2009.

“Adults aged ≥65 years who are dually enrolled in Medicare and Medicaid are an at-risk group in health care,” the authors noted. “However…the outcomes of women with gynecologic cancers in this population are unknown.”

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Using multivariate analysis and survival curves, they found that dual enrollees had an increased all-cause mortality overall as well as within each cancer site. An increased risk of advanced-stage disease at time of diagnosis among dual enrollees was only found in patients with uterine cancer.

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Additionally, survival curves demonstrated that the strongest disparity was among women with early-stage uterine and vulvar/vaginal cancers.

“Because these malignancies are generally curable, [women with uterine and vulvar/vaginal cancers] have the most potential for benefit from targeted interventions,” the authors concluded.


  1. Doll KM, Meng K, Basch EM, et al. Gynecologic cancer outcomes in the elderly poor: A population-based study. Cancer. [epub ahead of print.] 2015. doi: 10.1002/cncr.29541.