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Lack of Insurance Linked to Advanced-Stage Cervical Cancer

The study, published in the July 19 online issue of the American Journal of Public Health, reviewed the association between late-stage (stages III and IV) cervical cancer and both insurance and age in 69,739 women diagnosed with invasive cervical cancer between 2000 and 2007 in the National Cancer Database. More than half (55.5%) of privately insured cervical cancer patients in the observed population had stage I disease at diagnosis, compared with 40.2% of Medicaid recipients and 36.4% of uninsured patients. Advanced cervical cancer (stages III and IV) was diagnosed in 24.0% of privately insured women, in 34.5% of those with Medicaid, and in 35.2% of those without insurance. The rate of advanced disease also increased with age; the adjusted relative risk among women 35 years of age or older was 1.25 to 2.5 times that of women aged 21 to 34 years. The authors concluded: “Advanced-stage disease leads not only to poorer quality of life and greater morbidity, but often to higher treatment costs as well. Screening should be made accessible and affordable for all women for whom it is recommended, especially for those at higher risk of advanced-stage disease, such as middle-aged women, Medicaid recipients, and uninsured women.” The American Cancer Society estimates that 12,170 women will be diagnosed with cervical cancer and that 4,220 women will die from the disease in 2012. Although incidence and mortality from cervical cancer have declined dramatically since the introduction of the Pap test, one in three cervical cancer patients is diagnosed only after the cancer has spread to nearby organs, and one in ten is diagnosed only after the disease has spread to distant organs (35% and 11% respectively). The 5-year relative survival rate is 91% for patients with localized disease, but is only 58% for patients with regional disease and 17% for those with distant disease. Visit the American Cancer Society's Web site for more information.

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