Lack of Health Insurance Affects Survival in Uterine Cancer
Survival rate for all stages of uterine cancer is about 84 percent, but if it is diagnosed at its earliest stages, survival can be 90 to 95 percent. However, a lack of health insurance can have a negative impact on survival among women with uterine cancer, according to a new study.
Survival in uterine cancer patients is affected by insurance
Uterine cancer is often referred to as endometrial cancer because more than 95 percent of cases affect the endometrium, which is the lining of the uterus. It is the most common cancer of the female reproductive system in the United States and typically develops over many years, arising from less serious conditions such as endometrial hyperplasia (excessive cell growth in the uterine lining).
Most cases of uterine cancer occur in postmenopausal women, although up to 25 percent may appear before menopause. The good news is that most uterine cancers are found early because of warning signs such as irregular bleeding or postmenopausal bleeding.
Data from the new study, which were presented at the Third AACR Conference on The Science of Cancer Health Disparities, showed that African-American women were twice as likely to die of uterine cancer within four years when compared with Caucasian women. “However, when insurance, treatment and clinical factors were accounted for, this likelihood decreased to 30 percent greater,” according to Dana Chase, MD, a clinical fellow at the University of California, Irvine.
Overall, the researchers evaluated data from 178,891 patients in the National Cancer Database. The patient population was composed of about 74 percent white women, 9 percent African-Americans, 5 percent Hispanic, and the remaining patients did not provide specific racial information.
The unadjusted four-year survival rates were 80.7 percent among women who did not have health insurance, 75.93 percent for those who had Medicaid, 79.45 percent for younger Medicare patients, 69.35 for older Medicare patients, and 88.93 percent for those who had private health insurance.
However, the unadjusted four-year survival rate was 82 percent for Caucasian and Hispanic women, but only 63 percent for African-American women. The researchers found that some of the differences in survival by race were associated with women who had more advanced disease at diagnosis. However, even after disease severity was accounted for, African-American women had poorer survival when compared with white patients.
Once the researchers made adjustments for demographic and clinical factors, they found that women without health insurance were 1.46 times more likely to die within four years, while women with Medicaid and younger women with Medicare were 1.74 and 2.5 times as likely to die within four years when compared to women who had private health insurance, respectively.
Chase pointed out that although other factors may have a role in minority women’s access to care, “it’s clear from this study that [health] insurance definitely plays a role” in survival among women who have uterine cancer. For more information on cancer health disparities, the American Association for Cancer Research offers a video on its website.
American Association for Cancer Research
MD Anderson Cancer Center