Death likelier for uninsured cancer patients

ATLANTA — Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind.

People without health insurance are less likely to get recommended cancer screening tests, the study also found, confirming earlier research. And when these patients finally do get diagnosed, their cancer is likely to have spread.

The research by scientists with the American Cancer Society found that 35 percent of uninsured patients had died at the end of five years, compared with 23 percent of privately insured patients.

An Associated Press estimate — based on hospital cancer deaths in 2005 gathered by the U.S. Agency for Healthcare Research and Quality information and other data — suggests that at least 20,000 of the nation’s 560,000 annual cancer deaths are uninsured when they die. Experts said that estimate sounds reasonable.

One reason is that most fatal cancers occur in people 65 or older, an age group covered by the federal Medicare program. Another is that more than 80 percent of adults under 65 have some form of coverage, including private insurance or the Medicaid program for the poor, according to various estimates.

Some are enrolled in Medicaid or other programs after diagnosis, when the condition worsens and their finances erode. But such eleventh-hour coverage can be too late; early detection is the key to catching many cancers before they’ve grown beyond control, experts said.

“Insurance makes a big difference in how early you are detecting disease,” said Ken Thorpe, an Emory University health policy researcher.

The new findings are consistent across different racial groups. However, the fact that whites have better survival rates cannot be explained by insurance status alone, said Elizabeth Ward, the study’s lead author.

The researchers were not able to tell if the numbers were influenced by patients’ education levels or by other illnesses.