Caucasian and African American patients with prostate cancer who are insured privately may have different clinical outcomes, but these disparities are less pronounced among patients covered by Medicaid, according to a study published in Cancer.1

For this study, investigators tapped into the Surveillance, Epidemiology, and End Results database to identify and review data from 155,524 men younger than 65 years who were diagnosed with prostate cancer. For patients with localized disease, investigators assessed the correlation between insurance, receipt of therapy, and prostate cancer-specific mortality (PCSM).

Regardless of race, patients with Medicaid were less likely to receive definitive treatment (adjusted odds ratio [AOR], 0.67; 95% CI, 0.62-0.71), more likely to present with metastatic disease (AOR, 4.27; 95% CI, 4.01-4.55), and have higher PCSM (adjusted hazard ratio, 1.83; 95% CI, 1.50-2.24) compared with patients with private insurance.

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For patients with private insurance, significant associations between race and outcomes were observed for PCSM (AOR, 1.2; 95% CI, 1.03-1.40; P = .019) and for presentation with metastatic disease (AOR, 1.13; 95% CI, 1.06-1.21; P < .001).

Among patients with Medicaid, there were no disparities observed between race and outcomes with regard to PCSM (AOR, 0.79; 95% CI, 0.52-1.20; P = .272) and metastatic disease (AOR, 0.91; 95% CI, 0.80-1.03; P = .139), though outcomes for patients on Medicaid were worse overall compared with outcomes for patients with private insurance.

The authors concluded that efforts must be made to close the gap in outcomes and race for patients with private insurance, and that “further research regarding the impact of different insurance plans on cancer-related care such as prevention, detection, treatment, and quality of care provided for patients with cancer appears warranted.”


  1. Mahal AR, Mahal BA, Nguyen PL, Yu JB. Prostate cancer outcomes for men aged younger than 65 years with Medicaid versus private insurance. Cancer. 2017 Oct 30. doi: 10.1002/cncr.31106 [Epub ahead of print]