Worse Gynecologic Cancer Outcomes in Women Enrolled in Both Medicare, Medicaid

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.”

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.

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.

Reference

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.