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Report: Uninsured Adolescents and Young Adults More Likely to Be Diagnosed With Advanced Cancer

Study identifies age groups that have benefitted least from cancer progress (February 24)

A new study from the American Cancer Society shows that uninsured adolescents and young adults were far more likely to be diagnosed with late-stage cancer, which is more difficult and expensive to treat and more deadly, compared with young patients with health insurance. The study, published early online, will appear in the March issue of Cancer.

The authors say that their data suggest a way forward for cancer-control efforts in the adolescent and young adult (AYA) population — a group that has benefited the least from recent progress in cancer.

For their study, the researchers analyzed data from nearly 260,000 cancer patients aged 15 to 39 years in the National Cancer Database.

After adjusting for age, race/ethnicity, facility type, ZIP code-based income, education levels, and U.S. Census region, it was found that uninsured males were 1.51 times more likely to be diagnosed at an advanced stage of disease compared with patients with private insurance. Among females, the effect of insurance was even more pronounced, with uninsured patients found to be 1.86 times more likely to be diagnosed at an advanced stage.

Uninsured patients were younger, more likely to be male, more likely to be black or Hispanic, more likely to reside in the South, more likely to be treated in teaching/research facilities, and less likely to be treated in National Cancer Institute-designated facilities. Uninsured patients were also more likely to reside in ZIP codes with the lowest median income, as well as in ZIP codes with the highest percentage of residents without a high school diploma.

“We believe that this observation holds the promise of improved cancer-control efforts in the AYA population, after decades in which AYA patients have experienced far less victory in the war on cancer than their younger and older counterparts,” the authors conclude. “However, the success of these efforts may be directly tied to the fate of the Medicaid expansion component of the Patient Protection and Affordable Care Act, which, at the time of this writing, remains quite unclear.”

Source: ACS; February 24, 2014.

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