A new study finds disruptions in health insurance coverage are common in the United States and are associated with poorer cancer care and survival. The study was published in The Journal of the National Cancer institute.
For years, experts have known that lack of health insurance coverage is associated with poor access and receipt of cancer care and survival in the United States. Meanwhile, disruptions in coverage are common among low-income populations and little is known how these disruptions can affect cancer care, from prevention and screening to diagnosis, treatment, and survival.
Disruptions can be caused by gaps in coverage or transitions between types of coverage (e.g., public and private) or between specific health insurance plans.
Researchers, led by American Cancer Society’s Robin Yabroff, conducted a systematic review of studies of health insurance coverage disruptions and cancer care and outcomes published between 1980 and 2019. They identified 29 observational studies for analysis.
In those studies, from 4.3% to 32.8% of adults experienced coverage disruptions. Those with coverage disruptions were less likely to receive cancer prevention or screening, and if diagnosed with cancer, they were more likely to have advanced disease, were less likely to receive treatment, and have worse survival than their counterparts without coverage disruptions.
“Our findings were consistent across multiple cancer sites, with several studies finding a ‘dose-response’ relationship, meaning the longer the disruption, the worse the care,” lead author Yabroff said in a statement. “The consistency of these findings across the cancer control continuum in our review highlights how important it is to minimize breaks in health insurance coverage to address cancer disparities and promote health equity.”
