Public Insurance Tied to Lower Cancer Survival in Young Patients

Young, low-income patients with bone or soft tissue sarcomas have decreased overall survival (OS), regardless of disease stage at presentation, according to a study published online December in Cancer Medicine.

Neela L. Penumarthy, M.D., from Seattle Children's Hospital, and colleagues used data from the University of California San Francisco Cancer Registry to identify patients aged 0 to 39 years diagnosed with bone or soft tissue sarcomas between 2000 and 2015. The analysis examined how public insurance influenced five-year OS among young patients.

The researchers identified 1,106 patients, of whom 39 percent were classified as low-income (defined as no insurance or Medicaid). Low-income patients were more likely to be racial/ethnic minorities and to present with metastatic disease (odds ratio, 1.96). OS was significantly worse among low-income patients (61 versus 71 percent). OS was independently predicted by age at diagnosis and extent of disease at diagnosis. Low-income patients consistently had significantly worse OS when stratified by extent of disease (localized: 78 versus 84 percent; regional: 64 versus 73 percent; metastatic: 23 versus 30 percent). Metastatic disease at diagnosis accounted for 15 percent of the effect of public insurance on OS.

"It's important that publicly insured patients are supported by concrete resources to maximize their opportunity for survival," a coauthor said in a statement.

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