A comprehensive study led by researchers from the American Cancer Society (ACS) has unveiled that inadequate health insurance coverage significantly contributes to racial and ethnic disparities in the advanced-stage diagnosis of various cancers. The critical findings, which highlight the urgency of the issue, are published today in the Journal of the National Cancer Institute.
Dr. Parichoy Pal Choudhury, Principal Scientist specializing in Biostatistics at the American Cancer Society and the lead author of the study, emphasized, “Health insurance coverage is a key determinant of access to high-quality health care across the cancer continuum from prevention to early detection, treatment, and survivorship in the United States.” He added that these findings could inform effective policies designed to enhance health insurance coverage for all populations, ultimately benefiting those most in need.
In this extensive study, researchers meticulously analyzed data from 1.9 million cancer patients aged 18 to 64 who were diagnosed with one of ten major cancers between the years 2013 and 2019. This data came from the comprehensive National Cancer Database (NCDB), which encompasses hospitals across the nation. The ten cancers investigated—including breast (female), prostate, colorectum, lung, cervix, head and neck, stomach, urinary bladder, uterus, and skin melanoma—are typically amenable to early detection through appropriate screening, thorough physical examinations, or noticeable clinical symptoms.
The results of the study demonstrated that health insurance coverage played a mediating role in the disparities observed between non-Hispanic Black and White patients in eight specific cancers, with a range of proportions mediated from 4.5% to 29.1%. Additionally, disparities among Hispanic and non-Hispanic White patients were noted in six cancers, with mediation proportions spanning from 13.2% to 68.8%. Furthermore, disparities between non-Hispanic Asian/Pacific Islander and White patients were identified in three cancers, with mediation values between 5.8% and 11.3%. Overall, health insurance was found to account for a considerable share of racial and ethnic disparities in the diagnoses of stage III-IV cancers across a wide variety of malignancies.
“Securing health insurance for everyone is critical,” stressed Pal Choudhury. He elaborated that ensuring universal access to health care is likely to lead to decreased racial and ethnic disparities regarding the stage of cancer at diagnosis, which in turn could enhance cancer survival rates across diverse communities.
The American Cancer Society Cancer Action Network (ACS CAN) remains committed to advocating for the protection and strengthening of provisions within the Affordable Care Act (ACA). The network is actively urging Congress to make permanent the enhanced tax credits of the ACA Marketplace, which are set to expire at the conclusion of 2025. These credits have played a pivotal role in increasing health insurance coverage among historically marginalized communities. Furthermore, they are advocating for the Supreme Court to uphold access to no-cost preventive care in the ongoing case of Braidwood vs. Becerra.
“This study builds on the extensive amount of evidence showing the importance of health insurance coverage and underscores the need for elected officials to prioritize access to care for everyone,” stated Lisa A. Lacasse, president of ACS CAN. She remarked on the transformative impact of the ACA, highlighting its provisions that have meaningfully improved the healthcare landscape and reduced barriers for cancer patients, survivors, and their families. “We urge lawmakers and the courts to preserve and strengthen these critical patient protections so that all individuals are afforded a fair opportunity to prevent, detect, treat, and survive cancer,” she added.
Other prominent researchers from ACS who contributed to this impactful study include Dr. Leticia Nogueira, Dr. Ahmedin Jemal, and the senior author, Dr. Farhad Islami.
More information: Parichoy Pal Choudhury et al, Contribution of health insurance to racial and ethnic disparities in advanced stage diagnosis of 10 cancers, Journal of the National Cancer Institute (2024). DOI: 10.1093/jnci/djae242, academic.oup.com/jnci/advance- … jnci/djae242/7848760
Provided by American Cancer Society
Citation: Lack of health insurance coverage adds to disparities in advanced-stage diagnosis of multiple cancers, large study finds (2024, October 30) retrieved 30 October 2024 from
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**Interview with Dr. Parichoy Pal Choudhury on Health Insurance and Cancer Disparities**
**Editor:** Thank you for joining us today, Dr. Pal Choudhury. Your recent study highlights a pressing issue regarding health insurance coverage and its impact on cancer diagnoses. Can you summarize your findings for our audience?
**Dr. Pal Choudhury:** Thank you for having me. Our study found that inadequate health insurance significantly contributes to racial and ethnic disparities in the diagnosis of advanced-stage cancers. By analyzing data from nearly 1.9 million patients, we discovered that health insurance plays a crucial role in mediating disparities between different racial groups, particularly between non-Hispanic Black and White patients. It’s clear that when individuals have better access to health insurance, they tend to have earlier diagnoses and better outcomes.
**Editor:** That’s quite alarming. What specific disparities did your research identify, and how did health insurance influence these?
**Dr. Pal Choudhury:** We focused on ten major cancers and found that health insurance coverage mediates disparities particularly in cancers like breast, prostate, and lung. For example, between non-Hispanic Black and White patients, health insurance accounted for 4.5% to 29.1% of the differences in diagnosis at advanced stages. Among Hispanic and non-Hispanic White patients, the mediation was even more pronounced, spanning from 13.2% to 68.8%. This demonstrates that access to insurance is critical for equitable health care.
**Editor:** That brings to light the systemic issues within our healthcare framework. What do you see as the potential solutions moving forward?
**Dr. Pal Choudhury:** Securing universal health insurance is essential. Policymakers need to focus on enhancing coverage for marginalized populations. This includes making the enhanced tax credits from the Affordable Care Act permanent and ensuring access to no-cost preventive care. By addressing these issues, we can significantly reduce the disparities we currently see in cancer diagnoses, leading to better survival rates across all communities.
**Editor:** What role does the American Cancer Society Cancer Action Network play in advocating for these changes?
**Dr. Pal Choudhury:** ACS CAN is actively working to protect and strengthen provisions of the ACA, which have been instrumental in increasing coverage among historically marginalized communities. They are urging Congress to act before the 2025 deadline to make these tax credits permanent. Additionally, they are involved in key legal battles to ensure that preventive care remains accessible without financial burden.
**Editor:** what message would you like our readers to take away from your study?
**Dr. Pal Choudhury:** I want readers to understand that health insurance is not just a policy issue; it is a health equity issue. Access to quality healthcare, including cancer screening and treatment, should be a right for everyone, regardless of their racial or ethnic background. By advocating for systemic changes, we can pave the way for a healthier future for all individuals.
**Editor:** Thank you, Dr. Pal Choudhury. Your insights are invaluable in understanding the intersection of health insurance and cancer disparities. We appreciate your time and expertise.
