Impact of health insurance and socioeconomic status in the outcome of cancer and cardiac diseases

Lestuzzi, Chiara

doi:10.1016/j.ijcard.2021.09.032

Cited by 4 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In private insurance countries, the economic disparity may impact the outcomes of the patients as non-insured patients are less likely to receive costly treatments. However, also countries with national healthcare system may not always guarantee a full equity of care ( 32 ). The health insurance status is also related to the socioeconomic status.…”

Section: Discussionmentioning

confidence: 99%

Geographic variation in malignant cardiac tumors and their outcomes: SEER database analysis

et al. 2023

View full text Add to dashboard Cite

IntroductionPrimary malignant cardiac tumors (PMCTs) are rare. Geographical distribution has been demonstrated to affect cancer outcomes, making the reduction of geographical inequalities a major priority for cancer control agencies. Geographic survival disparities have not been reported previously for PMCT and the aim of this study is to compare the prevalence and the long-term survival rate with respect to the geographic location of PMCTs using the Surveillance, Epidemiology, and End Results (SEER) research plus data 17 registries between 2000 and 2019.MethodsThe SEER database was queried to identify geographic variation among PMCTs. We classified the included states into 4 geographical regions (Midwest, Northeast, South and West regions) based on the U.S. Census Bureau-designated regions and divisions. Different demographic and clinical variables were analyzed and compared between the four groups. Kaplan Meier curves and Cox regression were used for survival assessment.ResultsA total of 563 patients were included in our analysis. The median age was 53 years (inter-quartile range (IQR): 38 - 68 years) and included 26, 90, 101, and 346 patients from the Midwest, Northeast, South, and West regions respectively. Sarcoma represented 65.6% of the cases, followed by hematological tumors (26.2%), while mesothelioma accounted for 2.1%. Treatment analysis showed no significant differences between different regions. Median overall survival was 11, 21, 13, and 11 months for Midwest, Northeast, South and West regions respectively and 5-year overall survival was 22.2%, 25.4%, 14.9%, and 17.6% respectively. On multivariate Cox regression, significant independent predictors of late overall mortality among the entire cohort included age (Hazard Ratio [HR] 1.028), year of diagnosis (HR 0.967), sarcoma (HR 3.36), surgery (HR 0.63) and chemotherapy (HR 0.56).ConclusionPrimary malignant cardiac tumors are rare and associated with poor prognosis. Sarcoma is the most common pathological type. Younger age, recent era diagnosis, surgical resection, and chemotherapy were the independent predictors of better survival. While univariate analysis revealed that patients in the South areas had a worse survival trend compared to other areas, geographic disparity in survival was nullified in multivariate analysis.

show abstract

Section: Discussionmentioning

confidence: 99%

Geographic variation in malignant cardiac tumors and their outcomes: SEER database analysis

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In line with our results, previous study found that socioeconomic status, such as insurance status, were associated with survival in patients with cardiac diffuse large B-cell lymphoma ( 38 ). The limitation of access to early detection, early diagnosis and early treatment caused by the low-income situation may explain the high incidence of lung metastases at diagnosis ( 38 – 40 ). Therefore, clinical physicians should pay more attention to screening and detecting distant metastases, particularly lung metastases, and make better diagnosis and treatment strategies for PMCT patients with lung metastases.…”

Section: Discussionmentioning

confidence: 99%

Metastatic patterns and prognosis of patients with primary malignant cardiac tumor

Guan

Wei

Tang

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundDistant metastases are independent negative prognostic factors for patients with primary malignant cardiac tumors (PMCT). This study aims to further investigate metastatic patterns and their prognostic effects in patients with PMCT.Materials and methodsThis multicenter retrospective study included 218 patients with PMCT diagnosed between 2010 and 2017 from Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression was utilized to identify metastatic risk factors. A Chi-square test was performed to assess the metastatic rate. Kaplan–Meier methods and Cox regression analysis were used to analyze the prognostic effects of metastatic patterns.ResultsSarcoma (p = 0.002) and tumor size¿4 cm (p = 0.006) were independent risk factors of distant metastases in patients with PMCT. Single lung metastasis (about 34%) was the most common of all metastatic patterns, and lung metastases occurred more frequently (17.9%) than bone, liver, and brain. Brain metastases had worst overall survival (OS) and cancer-specific survival (CSS) among other metastases, like lung, bone, liver, and brain (OS: HR = 3.20, 95% CI: 1.02–10.00, p = 0.046; CSS: HR = 3.53, 95% CI: 1.09–11.47, p = 0.036).ConclusionPatients with PMCT who had sarcoma or a tumor larger than 4 cm had a higher risk of distant metastases. Lung was the most common metastatic site, and brain metastases had worst survival among others, such as lung, bone, liver, and brain. The results of this study provide insight for early detection, diagnosis, and treatment of distant metastases associated with PMCT.

show abstract

“…Lifelong monitoring of all survivors is not feasible due to its unaffordable costs ( 140 , 141 ). However, even in countries with a National Health System providing free medical care to all citizens, patients of low socio-economic status may not receive optimal care ( 142 ). Inexpensive tests, such as an ECG, can be provided as basic screening in survivors of childhood cancers, but more expensive and time-consuming tests should be limited to selected high-risk patients ( 143 ).…”

Section: Socio-economic Impact Of Survivorship Carementioning

confidence: 99%

Cancer survivorship at heart: a multidisciplinary cardio-oncology roadmap for healthcare professionals

Bisceglia,

Canale,

Silvestris

et al. 2023

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

In cancer, a patient is considered a survivor from the time of initial diagnosis until the end of life. With improvements in early diagnosis and treatment, the number of cancer survivors (CS) has grown considerably and includes: (1) Patients cured and free from cancer who may be at risk of late-onset cancer therapy-related cardiovascular toxicity (CTR-CVT); (2) Patients with long-term control of not-curable cancers in whom CTR-CVT may need to be addressed. This paper highlights the importance of the cancer care continuum, of a patient-centered approach and of a prevention-oriented policy. The ultimate goal is a personalized care of CS, achievable only through a multidisciplinary-guided survivorship care plan, one that replaces the fragmented management of current healthcare systems. Collaboration between oncologists and cardiologists is the pillar of a framework in which primary care providers and other specialists must be engaged and in which familial, social and environmental factors are also taken into account.

show abstract

Impact of health insurance and socioeconomic status in the outcome of cancer and cardiac diseases

Cited by 4 publications

References 16 publications

Geographic variation in malignant cardiac tumors and their outcomes: SEER database analysis

Geographic variation in malignant cardiac tumors and their outcomes: SEER database analysis

Metastatic patterns and prognosis of patients with primary malignant cardiac tumor

Cancer survivorship at heart: a multidisciplinary cardio-oncology roadmap for healthcare professionals

Contact Info

Product

Resources

About