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Disparities in Management of Cervical Cancer

Gynecol Oncol; ePub 2016 Mar 21; Churilla, Egleston, et al

Disparities exist in both the management and outcome of cervical cancer in the US in regard to health insurance status, and these disparities resulted in inferior cancer specific and overall survival (OS) observed among Medicaid and uninsured patients. This according to an analysis of 11,714 invasive cervical cancer cases (60% insured, 31% Medicaid, and 9% uninsured) in patients aged 18 to 64 years from 2007 to 2011. Researchers found:

• FIGO III/IV stage at presentation was more frequent with Medicaid (40%) and uninsured (42%) compared to insured patients (28%).

• For FIGO IA2-IB1 patients, receipt of definitive surgery was inversely associated with uninsured status (OR=0.65) in univariable analysis.

• For FIGO IB2-IVA patients, the use of suboptimal radiation therapy (RT) was associated with uninsured status (OR=1.33) in adjusted analyses.

• Among all patients, overall mortality was increased with Medicaid (HR=1.16) and uninsured status (HR=1.17) in multivariable analysis.

• Cancer-specific mortality survival trended toward significance in multivariable analyses for both Medicaid (HR=1.11) and uninsured status (HR=1.14).

Citation: Churilla T, Egleston B, Dong Y, et al. Disparities in the management and outcome of cervical cancer in the United States according to health insurance status. [Published online ahead of print March 21, 2016]. Gynecol Oncol. doi:http://dx.doi.org/10.1016/j.ygyno.2016.03.025.