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Uninsured Women More Likely to Die From Breast Cancer

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A study has found that women without insurance who were diagnosed with breast cancer were 60% more likely to die from the disease.

Uninsured women also were nearly 2.6 times more likely to be diagnosed with a later stage of the disease, compared to women who had health insurance.

The research was published online by the journal Cancer on April 25, 2017. Read the abstract of “Breast cancer stage variation and survival in association with insurance status and sociodemographic factors in US women 18 to 64 years old.”

To do the study, the researchers analyzed information in the SEER databases. The SEER databases are large registries of cancer cases from sources throughout the United States maintained by the National Institutes of Health.

The researchers looked at information from 52,048 women ages 18 to 64 who were diagnosed with breast cancer in 2007 and 2008. They used statistical models to analyze the relationship between insurance status and stage at diagnosis and survival.

The researchers also found that women with Medicaid insurance were more likely to be diagnosed with later-stage cancer and have worse survival rates than women with private health insurance, though women with Medicaid insurance had better outcomes and diagnoses than uninsured women.

The researchers also reported that lower percentages of uninsured Black, unmarried, and younger women survived for 5 years after a breast cancer diagnosis compared to uninsured women who were white, married, and older than 40.

“Access to screening services may play a role in the association between insurance status and breast cancer stage at diagnosis and survival,” said lead author Kimberly Johnson, associate professor of epidemiology at Washington University in St. Louis. “Improving access to primary care and mammography screenings in these populations may improve breast cancer outcomes.”

These results echo earlier studies that found that women with either no insurance or Medicaid insurance were more likely to be diagnosed with more advanced-stage disease. This could be because women with Medicaid or no insurance are less likely to get screening mammograms, so breast cancers are diagnosed later, at a more advanced stage. It’s not clear why women on Medicaid are less likely to get screening mammograms; some research suggests that it’s harder for women on Medicaid to schedule a mammogram appointment.

ALL women -- no matter their age, ethnicity, economic status, or insurance status -- deserve the best breast healthcare possible. Differences that affect cancer outcomes, such as screening, access to care, and quality and consistency of care, should be eliminated.

Screening is a good place to start. Breast cancer that is diagnosed early is typically easier to treat and offers the best survival chances. Regular screening for breast cancer, including annual mammograms and breast exams by a medical professional, is important for everyone. Paying for healthcare can be difficult, especially if you have a limited income and no or inadequate health insurance or are covered only by Medicare. But if you're older than 40, skipping regular mammograms is NOT an option. Stick with the screening plan you and your doctor decide is best for you. If scheduling problems or cost concerns are stopping you from getting a mammogram, talk to your doctor, a hospital social worker, or a staff member at a mammogram center. Ask about free mammogram programs and healthcare services in your area. It's YOUR health and YOUR future and you deserve the best care possible.

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