Time to diagnosis of pediatric cancer and factors that require attention

Ribeiro, Isabella Lima Arrais; Melo, Ana Carolina Rodrigues de; Santiago, Bianca Marques; Bonan, Paulo Rogério Ferreti; Serpa, Eliane Batista de Medeiros; Valença, Ana Maria Gondim

doi:10.1007/s10389-021-01517-x

Cited by 1 publication

(2 citation statements)

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“…However, the relationship between diagnostic delay and cancer stage can also be complicated by disease aggressiveness with fast‐growing cancers showing early symptoms, which may lead parents to seek medical attention for their child much sooner than slow‐growing cancers, resulting in an earlier diagnosis 3 . This complexity might partially lead to the inconsistent findings between diagnosis delay and cancer diagnosis stage 17‐19 …”

Section: Discussionmentioning

confidence: 99%

“…3 This complexity might partially lead to the inconsistent findings between diagnosis delay and cancer diagnosis stage. [17][18][19] Health insurance coverage, as one of the few modifiable resources that may contribute to racial/ethnic disparities, can help ensure timely access to health care resources and high-quality care. Prior studies in newly diagnosed patients with cancer aged 15-29 years have found that those with public or no insurance tend to have a longer delay in diagnosis and present with a more advanced stage, compared with those who are privately insured.…”

Section: Figurementioning

confidence: 99%

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The impact of health insurance coverage on racial/ethnic disparities in US childhood and adolescent cancer stage at diagnosis

Wang

Brown

Cao

et al. 2022

Cancer

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Background Racial/ethnic minority children and adolescents are more likely to have an advanced cancer diagnosis compared with non‐Hispanic Whites, which may relate to the lack of consistent health care access. This study aims to describe racial/ethnic disparities in cancer diagnosis stage among children and adolescents and assess whether health insurance mediates these disparities. Methods Data on individuals ≤19 years of age diagnosed with primary cancers from 2007 to 2016 were obtained from the Surveillance, Epidemiology, and End Results 18 database. Prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between race/ethnicity and cancer diagnosis stage were calculated using Poisson regression. Analyses addressing health insurance as a potential mediator were also performed. Results Compared with non‐Hispanic Whites, racial/ethnic minorities had a higher prevalence of a distant cancer diagnosis, with PRs of 1.31 (95% CI, 1.23–1.40) for non‐Hispanic Blacks, 1.14 (95% CI, 1.04–1.24) for non‐Hispanic Asian/Pacific Islanders, and 1.15 (95% CI, 1.09–1.21) for Hispanics. These associations were attenuated when adjusting for health insurance, with PRs of 1.24 (95% CI, 1.16–1.33) for non‐Hispanic Blacks, 1.11 (95% CI, 1.02–1.21) for non‐Hispanic Asian/Pacific Islanders, and 1.07 (95% CI, 1.01–1.13) for Hispanics. Any Medicaid or no insurance at diagnosis mediated 49%, 22%, and 9% of the observed association with distant stage in Hispanics, non‐Hispanic Blacks, and non‐Hispanic Asian/Pacific Islanders, respectively. Conclusions Disparities in cancer diagnosis stage in racial/ethnic minority children and adolescents may be partially explained by health insurance coverage. Further research is needed to understand the mechanisms.

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Section: Discussionmentioning

confidence: 99%