Uninsured More Likely to Die From Cancer Following Diagnosis

By Steven Reinberg
HealthDay Reporter
Thursday, December 20, 2007; 12:00 PM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

THURSDAY, Dec. 20 (HealthDay News) -- People diagnosed with cancer who don't have health insurance are more likely to die because they are less likely to get screening tests and so are typically diagnosed with advanced disease, a new study from the American Cancer Society finds.

The finding proffers strong evidence that differences in cancer survival are directly related to lack of access to health care.

"If you are uninsured, and you are diagnosed with cancer, you have a 60 percent greater chance of dying from cancer than if you were insured and diagnosed with cancer," said Dr. Otis Brawley, chief medical officer at the cancer society.

"There is not a cohort of insured and a cohort of uninsured cancer patients that have the same five-year survival," Brawley added. "It's always the uninsured who do worse."

Part of the problem is that uninsured people don't have access to screenings, Brawley said. "But part of it is that uninsured people don't have access to the best doctors or have access to good doctors who are overwhelmed. The end result is the quality of care the poor folks get is not as good as the quality of care of the wealthier or the insured," he said.

There are also people who are underinsured, Brawley said. While these people have access to care, high co-pays and deductibles make the care unaffordable, particularly high-priced chemotherapy drugs, he noted.

"Where it becomes frightening and morally reprehensible is people who have significant pain and can't get narcotics and other pain medications they need, because they can't afford them," Brawley said.

People don't realize they are underinsured until after they have gotten sick, Brawley said. "There are a substantial number of Americans who don't realize they are a cancer diagnosis away from economic disaster," he noted.

The study, in the January/February issue of CA: A Cancer Journal for Clinicians, used data from the National Cancer Database, which is the only national registry that collects data on patient insurance.