The Impact of Insurance and Marital Status on Survival in Patients with Nasopharyngeal Carcinoma

Abstract

Objective: This study aimed to explore the influence of social support on the survival outcomes of patients with nasopharyngeal carcinoma (NPC). We examined whether the combined proxy influenced whether patients were more likely to receive radiotherapy. Methodology: data were collected from the 18 registries of the National Cancer Institute’s Surveillance, Epidemiology, and End Results database. The association between both insurance status and marital status and disease-specific survival rates were evaluated with a multivariate Cox proportional-hazards regression model to calculate the hazard ratios and associated confidence intervals. Odds ratio (OR) computed by logistic regression was also used to examine the relationship between the receipt of radiotherapy and insurance and marital status. Results: insured and uninsured patients differed significantly in T-stage, N-stage, M-stage, radiotherapy use, race, and marital status. The uninsured-non-married patients showed the lowest 5-year disease-specific survival rates. We further found unmarried patients with either Medicaid (OR, 0.40), or no insurance (OR, 0.24) had lower odds of receiving radiotherapy than those with insurance at diagnosis. Conclusions: uninsured-unmarried NPC patients had a significantly higher risk of distant metastasis at diagnosis, poorer 5-year disease-specific survival, and were less likely to receive radiotherapy than insured-married patients.

Small Cell Carcinoma as an Independent Prognostic Factor for Cervical Cancer Patients: A Population-Based Analysis

“…This could be explained by the fact that socioeconomic psychological factors and genetic diversity might play an important role in tumorigenesis and tumor progression [18,19]. Several previous studies demonstrate that marital status and ethnicities were important etiological and prognostic factors in several solid tumors, including cervical cancer [20][21][22][23]. Similarly, in our study, better survival was seen in married patients and in white women.…”

Small Cell Carcinoma as an Independent Prognostic Factor for Cervical Cancer Patients: A Population-Based Analysis

“…This could be explained by the fact that socioeconomic psychological factors and genetic diversity might play an important role in tumorigenesis and tumor progression (20)(21)(22). Several previous studies did demonstrate that marital status and ethnicities were important etiological and prognostic factors in several solid tumors, including cervical cancer (23)(24)(25)(26). Similarly, in our study better survival was seen in married patients and in white women.…”

Socioeconomic Status and Survival in Nasopharyngeal Carcinoma: A Population‐Based Study

“…Wang et al demonstrated that uninsured, unmarried patients with NPC had a higher risk of metastases, were less likely to receive radiation, and had a poorer 5-year disease-specific survival rate than their insured, married counterparts. 9 Insurance status provides merely a proxy for SES. Another study found poorer overall survival of Taiwanese patients with NPC was associated with male sex, older age, and low income.…”

“…Prior studies have demonstrated links between factors involved in SES and survival in NPC. Wang et al demonstrated that uninsured, unmarried patients with NPC had a higher risk of metastases, were less likely to receive radiation, and had a poorer 5‐year disease‐specific survival rate than their insured, married counterparts 9 . Insurance status provides merely a proxy for SES.…”