Abstract
Insurance status as a modifier of the association between race and stage of prostate cancer diagnosis in Florida
Julieta Morano1, Evelyn Ramirez1, Tiffany Beguiristain1 and Noël C Barengo2
(1)FIU, Miami, FL, (2)Herbert Wertheim College of Medicine, Florida International University, Miami, FL
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Cancer stage at diagnosis is an important prognostic factor regarding a patient’s health outcomes. The objective of this study was to investigate whether insurance status was a modifier of the association between race and stage of prostate cancer at the time of diagnosis in Florida between 1995 and 2013.
Methods: This secondary data analysis used information collected by the Florida Cancer Data System. Study participants included black and white males diagnosed for prostate cancer in Florida between 1995 and 2013 (n=224,819). Those missing data regarding race, stage of cancer at diagnosis, and/or insurance status were excluded. Logistic regression models were used to test the association between race, insurance status and stage at diagnosis. Statistical models were adjusted for age, ethnicity, geographic location, tobacco use status, and year of diagnosis.
Results: Black males were more likely to be diagnosed at a late stage (odds ratio (OR) 1.31; CI 1.27-1.35). Being uninsured or having Medicaid were associated with a diagnosis of late stage cancer (uninsured: OR 2.28; 95% CI 2.13-2.45; Medicaid: OR 1.84; 95% CI 1.70-1.98). When analyzing the data according to insurance status, insurance status specific ORs were similar to the crude OR. The ORs for an association between race and stage of diagnosis according to insurance status did not differ.
Conclusion: Insurance status was not a modifier of the association between race and stage at diagnosis. However, the race-disparities in regard stage of prostate cancer at diagnosis is of concern.
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