Lack of insurance linked to advanced stage cervical cancer

July 19, 2012

A large national sample of women diagnosed with cervical cancer between 2000 and 2007 finds lack of insurance was second only to age as the strongest predictor of late stage at diagnosis, a gap the authors say is likely attributable to lack of screening.

The estimates that 12,170 women will be diagnosed with and 4,220 women will die from the disease in 2012. Although incidence and mortality from cervical cancer have declined dramatically since the introduction of the , one in three cervical is diagnosed only after the cancer has spread to nearby organs and one in ten is diagnosed only after the disease has spread to distant organs (35% and 11% respectively). Prognosis is strongly related to stage: the 5-year relative survival rate is 91.2% for patients with localized disease, but only 57.8% for patients with regional disease and 17.0% for those with distant disease.

Socioeconomic status, race, marital status, and geographic location have all been identified as factors related to late stage at diagnosis among cervical cancer patients. Previous studies also documented age as a significant predictor of advanced stage, although the effects of age and also of , which are two of the strongest predictors of cervical cancer screening, had not been studied together prior to the current study.

For the current study, which appears early online in the , researchers led by Stacey Fedewa, MPH reviewed the association between late stage (stage III/IV) cervical cancer and both insurance and age, with adjustment for race/ethnicity and other sociodemographic and clinical factors on 69,739 women diagnosed with between 2000 and 2007 from the National Cancer Database.

More than half (55.5%) of privately insured cervical cancer patients in the observed population were at stage I at diagnosis, compared to 40.2% of Medicaid recipients, and 36.4% of uninsured patients. Meanwhile, 24.03% of privately insured women, 34.51% of those with Medicaid, and 35.22% of those without insurance were diagnosed with advanced disease, described as stages III and IV. Advanced stage also increased with age; the adjusted relative risk among women ≥35 years of age was 1.25 to 2.5 that of women 21-34 years.

"Late stage at diagnosis is likely attributable to underscreening," write the authors. They conclude: "Advanced-stage disease leads not only to poorer quality of life and greater morbidity, but often to higher treatment costs as well. Screening should be made accessible and affordable for all women for whom it is recommended, especially for those at higher risk of advanced-stage disease, such as middle-aged women, Medicaid recipients, and uninsured ."

Explore further: Age affects risk of being diagnosed with cancer at advanced stage

More information: "Association of Insurance Status and Age with Cervical Cancer Stage at Diagnosis: National Cancer Database, 2000-2007," Fedewa et al. Am J Public Health. Published online ahead of print July 19, 2012: e1–e9. doi:10.2105/AJPH.2011.300532

Related Stories

Age affects risk of being diagnosed with cancer at advanced stage

March 2, 2012
Older women with breast cancer face a higher risk of being diagnosed with the disease at a late stage, while the risk of an advanced stage diagnosis of lung cancer decreases with age, a new study shows today.

Regular smear tests boost chances of cure from 66 percent to 92 percent

March 2, 2012
Women can boost their chances of surviving cervical cancer substantially through regular cervical screening, claims a research paper published today in the British Medical Journal.

New study identifies pockets of high cervical cancer rates in North Carolina

March 12, 2012
A study of cervical cancer incidence and mortality in North Carolina has revealed areas where rates are unusually high.

Recommended for you

Researchers identify gene variants linked to a high-risk children's cancer

September 25, 2017
Pediatric researchers investigating the childhood cancer neuroblastoma have identified common gene variants that raise the risk of an aggressive form of that disease. The discovery may assist doctors in better diagnosing ...

Prostaglandin E1 inhibits leukemia stem cells

September 25, 2017
Two drugs, already approved for safe use in people, may be able to improve therapy for chronic myeloid leukemia (CML), a blood cancer that affects myeloid cells, according to results from a University of Iowa study in mice.

Cancer vaccines need to target T cells that can persist in the long fight against cancer

September 25, 2017
Cancer vaccines may need to better target T cells that can hold up to the long fight against cancer, scientists report.

Lung cancer treatment could be having negative health effect on hearts

September 25, 2017
Radiotherapy treatment for lung cancer could have a negative effect on the health of your heart new research has found.

MRI contrast agent locates and distinguishes aggressive from slow-growing breast cancer

September 25, 2017
A new magnetic resonance imaging (MRI) contrast agent being tested by researchers at Case Western Reserve University not only pinpoints breast cancers at early stages but differentiates between aggressive and slow-growing ...

Alternative splicing, an important mechanism for cancer

September 22, 2017
Cancer, which is one of the leading causes of death worldwide, arises from the disruption of essential mechanisms of the normal cell life cycle, such as replication control, DNA repair and cell death. Thanks to the advances ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.