Young Cancer Patients Fare Better on Private Insurance

The odds of surviving childhood cancer may be influenced by the type of health insurance a young patient has, researchers say.

In a new study, children and young adults covered by Medicaid or other government agencies were less likely to be alive five and 10 years after their cancer diagnosis than those with private insurance.

"Patients with Medicaid have less access to primary care and are more likely to face delays in diagnosis than patients with private insurance," explained study first author Dr. Neela Penumarthy. She is an oncologist in the department of pediatrics at the University of California, San Francisco (UCSF).

"While we found that publicly insured patients were more likely than those with private insurance to present with cancer that had already spread, this only accounted for part of the relationship between insurance and survival," Penumarthy added in a university news release.

The study included 1,100 children, teens and young adults with bone and soft-tissue sarcomas, which account for 12% to 15% of all pediatric tumors.

The researchers found that 61% of those with public insurance were alive five years after diagnosis, compared with 71% of patients with private insurance.

Ten years after diagnosis, the survival rates were 49% and 63%, respectively, according to the study published online Dec. 15 in the journal Cancer Medicine.

Rates of localized cancer -- when the disease is most responsive to treatment -- at the time of diagnosis were 45% among patients with private insurance and 36% among those with public insurance, the findings showed.

Rates of metastatic cancer -- when the disease has spread to other areas of the body -- at the time of diagnosis were 12.5% among patients with private insurance and just over 21% among patients with public insurance.

But even among patients who had metastatic cancer at the time of diagnosis, rates of survival were higher among those with private insurance (30%) than among those with public insurance (19%) after 10 years, the researchers found.

According to study senior author Dr. Lena Winestone, from the Helen Diller Comprehensive Cancer Center at UCSF, other factors that may affect outcomes for these patients include "obstacles to medical care, such as lack of transportation, social support and funds for deductibles and prescriptions."

Winestone added that "it's important that publicly insured patients are supported by concrete resources to maximize their opportunity for survival."

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