Relative importance of individual insurance status and hospital payer mix on survival for women with cervical cancer

Cherston, Caroline; Yoh, Katherine; Huang, Yongmei; Melamed, Alexander; Gamble, Charlotte; Prabhu, Vimalanand S.; Li, Yeran; Hershman, Dawn L.; Wright, Jason D.

doi:10.1016/j.ygyno.2022.06.023

Cited by 6 publications

(2 citation statements)

References 33 publications

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“…Patel et al conducted a study in California and reported that patients with Medicaid, insurance granted by the state, or those without any medical insurance had a higher incidence of cervical cancer [22], which coincides with the results of our research. Another study in the United States showed that Medicaid patients had a 38% increase in mortality (HR = 1.38; CI 95% 1.34-1.43), while uninsured patients had a 32% increase (HR = 1.32; CI 95%, 1.26-1.38), which may be associated with lower quality of care and reduced adherence to medical protocols in public hospitals [23]. On the other hand, the report on the situation of cancer in Colombia in 2021 reported that the incidence of cervical cancer was similar for both the contributory and subsidized regimes [24].…”

Section: Discussionmentioning

confidence: 99%

Association between Cervical Cancer and Dietary Patterns in Colombia

Meneses-Urrea,

Vaquero-Abellán,

Villegas Arenas

et al. 2023

Nutrients

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Cervical cancer is a global public health problem. It is the second leading cause of death among women of childbearing age worldwide. Several factors, including diet, have been shown to influence the risk of persistent HPV infection and tumor progression. This paper determines the relationship between dietary patterns and cervical cancer. It is an ecological study of multiple groups, based on two national sources: the High-Cost Account and the National Survey of Nutritional Situation of Colombia of 2015. The population consisted of 3472 women aged 35 to 64. The incidence of cervical cancer was used as the dependent variable while the independent variables included food consumption according to established patterns, area of residence, age, physical activity, and BMI, among other variables. The statistical analysis performed through associations between variables was evaluated by multiple linear regression using R2. 38.9% of the evaluated population belonged to the first quartile of wealth, and 76.5% resided in the municipal capital. The incidence of cervical cancer in Colombia was associated with being affiliated to a state-subsidized health regime and having diabetes mellitus. A conservative eating pattern, as well as belonging to a rural area, are evidenced as protective factors. These results invite the need to encourage public policies and promote healthy lifestyles.

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Section: Discussionmentioning

confidence: 99%

Association between Cervical Cancer and Dietary Patterns in Colombia

Meneses-Urrea,

Vaquero-Abellán,

Villegas Arenas

et al. 2023

Nutrients

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“…Moreover, given that this study excluded patients who were not enrolled in a health insurance plan for at least 3 consecutive years to accurately capture screening history, uninsured patients and those with inconsecutive enrollment were excluded. Given that uninsured status is associated with decreased cervical cancer screening, advanced stage at diagnosis, and decreased survival, [22][23][24][25] screening uptake and survival outcomes of uninsured patients in PR should be evaluated in future studies. Nonetheless, it is important to highlight that less than 10% of the population of PR is uninsured, and that the Breast and Cervical Cancer Early Detection Program (BCCEDP) 26 in PR currently offers screening services to the uninsured population.…”

Section: Discussionmentioning

confidence: 99%

Screening History and Survival Among Women With Cervical Cancer in Puerto Rico

Gómez-Vargas

Ortiz‐Ortiz

Almodovar-Rivera

et al. 2022

J Low Genit Tract Dis

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ObjectivesCervical cancer incidence is rising in Puerto Rico (PR). Screening for cervical cancer could prevent the occurrence of the disease or lead to its early detection, translating to survival benefits. In this study, we evaluated the association of cervical cancer screening status with tumor diagnosis and survival among Hispanic women living in PR.MethodsWe analyzed data for 506 incident cases of primary cervical cancer diagnosed from the period 2011–2014, identified through the PR Central Cancer Registry. We ascertained screening status 3 years before cervical cancer diagnosis using data from the period 2008–2014 from the PR Central Cancer Registry-Health Insurance Linkage Database. Patients were followed until 2019. Our outcomes of interest were stage at diagnosis and survival.ResultsMost women (78.86%) were covered by public insurance (Medicare and/or Medicaid), and 69.57% underwent screening 3 years before their diagnosis. The proportion of cases diagnosed with localized stage was significantly greater among the screened group compared with those unscreened (43.5% vs 33.1%, p < .0001). Multivariate analysis showed that women insured through Medicaid were less likely to have been screened when compared with women with private insurance (odds ratio = 0.29; 95% CI = 0.16–0.52). Five-year survival was significantly greater among screened (72%) than unscreened (54%) women (plog-rank < 0.05). The multivariate Cox proportional hazards model showed that women who received screening had a 39% (hazard ratio [HR] = 0.61; 95% CI = 0.43–0.87) lower risk of death compared with unscreened women.ConclusionOur findings exemplify survival benefits among women who underwent cervical cancer screening in PR. Interventions to improve screening uptake and adherence are a public health priority.

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Differences in Surgical Cancer Care Delivery and Outcomes Between Safety‐Net and Non‐Safety‐Net Hospitals in the United States: A Comprehensive Systematic Review

Alsalek,

Liu,

Han

et al. 2024

Journal of Surgical Oncology

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BackgroundStudies evaluating the association of safety‐net hospitals (SNHs) with outcomes of surgical care in cancer patients have demonstrated mixed results. We sought to systematically investigate the association of SNH status with measures of surgical cancer care delivery and outcomes.MethodsA comprehensive review of the literature identified from the MEDLINE/PubMed, Embase, Web of Science, and Cochrane databases was performed according to the PRISMA guidelines. Risk of bias assessment was conducted using the Joanna Briggs Institute's tool. The findings were synthesized qualitatively.ResultsOf the 1749 records identified, 33 retrospective studies were included, 79% of which investigated national databases. Risk of bias assessment revealed average score of 78%. Among studies assessing each outcome, lower likelihood of receiving appropriate surgical interventions in SNH patients was reported by 85%; longer intervals to surgery by 100%; and prolonged hospital stays by 73%. Most studies reported no differences in survival (65%) or readmission (67%). Results were mixed regarding complications and mortality. Patient characteristics and shortage of resources and interdisciplinary teams were frequently proposed factors for observed disparities.ConclusionsCancer patients at SNHs may be less likely to undergo some surgical treatments and experience longer intervals to treatment but achieve largely comparable short‐ and long‐term outcomes to non‐SNH patients.

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Relative importance of individual insurance status and hospital payer mix on survival for women with cervical cancer

Cited by 6 publications

References 33 publications

Association between Cervical Cancer and Dietary Patterns in Colombia

Association between Cervical Cancer and Dietary Patterns in Colombia

Screening History and Survival Among Women With Cervical Cancer in Puerto Rico

Differences in Surgical Cancer Care Delivery and Outcomes Between Safety‐Net and Non‐Safety‐Net Hospitals in the United States: A Comprehensive Systematic Review

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