Researchers from the University of Pittsburgh have reported that patients with “Medicaid/uninsured and Medicare disability were at increased risk of death after the diagnosis of squamous cell carcinoma of the head and neck (SCCHN) when compared with patients with private insurance.” The details of this study were published online on November 20, 2009 in Cancer.[1]

Unfortunately, underinsured or uninsured patients are reportedly at risk for impaired access to care, delays in medical treatment, and in some cases, substandard medical care. A recent article in the journal Cancer suggests that patients who are uninsured or those who receive Medicaid benefits may be at greater risk for developing postoperative complications and dying after surgery for colorectal cancer. Researchers from the Division of Cancer Prevention and Control and the Kentucky Cancer Registry have previously documented survival differences in patients with and without private health insurance. These findings were reported in the October 13, 2003 issue of the Archives of Internal Medicine.

The current study evaluated outcomes of 1,231 patients with head and neck cancer treated at the University of Pittsburgh. Patients were divided into those with Medicaid and uninsured status plus those with Medicare disability versus patients with private insurance. The hazard ratio for survival was 1.50 for patients defined as Medicaid/uninsured versus private insurance. The hazard ration for survival of Medicare disability patients was 1.69 compared with patients with private insurance. These increased rates of death were presented and then corrected for competing risk factors such as alcohol and tobacco use. Patients with SCCHN were also twice as likely to present with a more-advanced stage of disease and were more likely to have positive lymph nodes compared with patients with private insurance.

Comments: With over 40 million uninsured persons in the United States, these are deeply disturbing statistics.

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