Online Program

Effect of insurance status on all-cause and cancer-related survival in colorectal cancer

Monday, November 4, 2013

Minal Patel, M.S., College of Human Medicine, Michigan State University, Flint, MI
Introduction: Insurance status, SES and race are factors associated with advanced-stage colorectal cancer and decreased survival rates. Flint, Michigan has a unique population with 36.6% of citizens below the poverty line and a 62.6% non-white population. The purpose of this study is to measure the effect of insurance status and race on all-cause and cancer-related colorectal cancer survival in Flint, Michigan. Methods: Patient information was obtained from Hurley Medical Center's Tumor Registry for colorectal cancer patients aged 18-80 (n = 824) who were diagnosed or received first treatment here from 1993-2010 for 10 years post-treatment. Patients were stratified by age, gender, race, time-to-treatment and insurance status (private insurance versus nonprivate insurance-no insurance, Medicaid or Medicare). A life table survival analysis with Wilcoxon-Gehan statistic and chi-squared analysis were performed to assess impact on survival. Results: There was a statistically significant increase in cancer-related survival for private insurance holders (p = 0.035; median time 120 months), as well as a difference between age groups 0-64 vs. 65+ (p = 0.05). Private insurance holders also had higher median all-cause survival (94 months vs 35 months). When limiting time-to-treatment to 0-2 months, there was still a significant difference in all-cause survival between insurance groups. No difference in survival was detected for race or gender. Conclusions: Though many studies have shown race to be a significant factor in colorectal cancer survival, we did not find this to be the case in our population. Future studies should investigate other causes of survival discrepancies in this population.

Learning Areas:

Diversity and culture
Provision of health care to the public
Public health or related research

Learning Objectives:
Compare the effect of insurance status, age and race on all-cause and cancer-related colorectal cancer survival in Flint, Michigan.

Keyword(s): Access to Health Care, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal of $90,000 in total federal research grant funding to research breast cancer and colorectal cancer. I have conducted research in breast cancer and colorectal cancer mechanisms, chemoresistance and public health disparities in screening and survival for almost 8 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.