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.
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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.”