Results from a recent study by the Cancer Prevention Institute of California, revealed that health insurance type at diagnosis greatly impacts cancer outcomes especially in adolescent and young adult patients. published in the July 10, 2017 issue of Cancer Causes Control, researchers examined joint associations between sociodemographic factors — race/ethnicity, neighborhood socioeconomic status (nSES), and health insurance — and cancer survival for the most frequent cancers among AYAs. The Sentinel caught up with lead researcher on the study Mindy C. DeRouen, PhD, MPH, who was able to give some insight on the results.
“The study started back in 2012 and at the time I was working for a woman who was involved in a consortium for survival outcomes for adolescents and young adults,” DeRouen explained.
“The overarching impetus [for the study] was I wanted to look at the relationships between these variables, i.e. race, ethnicity, neighborhood, insurance status etc.”
The six cancer sites with the highest relative survival rates (thyroid, testis, melanoma, breast, Hodgkin’s lymphoma, and non-Hodgkin lymphoma) showed the strongest associations between no or public insurance and shorter survival, which suggests that insurance influences long-term care and survivorship in addition to the initial diagnosis and treatment period, according to the study.
“Often times individuals can have private insurance plans that don’t cover much of anything,” DeRouen said.
“You end up having to pay for things out of pocket Most individuals have deductibles. I you’re a young person and you’re looking to get cheap insurance you’re probably going to have a high deductible. In addition there are things like co-payments… if you’re diagnosed with cancer, your treatments may run into hundreds of thousands of dollars.
“In many cases insurance plans will cap out.”
Furthermore, according to researchers on the study, differences in receiving or completing treatment, cancer subtype, or neighborhood built and social factors (e.g., walkability, proximity to medical facilities, education and social support) by race/ethnicity or nSES may help explain this finding.
“We also know that lower income, non-white groups often get diagnosed at later stages. They know something’s wrong but they also know they can’t afford to go to the doctor.”
This may be because sometimes patients simply don’t’ know where to get assistance. But it’s not entirely hopeless DeRouen said. Financially strapped patients can get help.
“In California, adolescents (for example) who present with cancer and do not have insurance are automatically enrolled in Medi Cal so that they’re not left with nothing,” she said.
“Some people are not comfortable using the system or they’re not aware that there are ways for them to get help and they’re not aware of what they are.”
The research was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885 and the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute at the National Institutes of Health under contract HHSN2612010000140C awarded to the Cancer Prevention Institute of California. The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN2612010000140C awarded to the Cancer Prevention Institute of California.
