Dr. Churilla on Impact of Health Insurance Status on Patients With HNSCC

Thomas M. Churilla, MD, Department of Radiation Oncology, Fox Chase Cancer Center, discusses a study exploring the impact of health insurance status on the presentation, local management, and outcomes of patients with head and neck cancer.

For the study, researchers compiled data from the SEER database, looking at nearly 54,000 patients who were diagnosed with squamous cell carcinoma of the oral cavity, pharynx, and larynx from 2007 to 2012. The majority of patients did have health insurance, with approximately 15% having Medicaid and 5% being uninsured. Both the Medicaid and uninsured groups had similar clinical and demographic information. Regarding stage or presentation, patients insured were 40% more likely to present with stage I or II disease as well as T1 and/or distant-metastatic disease, compared with uninsured or Medicaid patients who presented with stage I/II disease 25% of the time.

Patients with uninsured or Medicaid status were less likely to undergo external-beam radiation therapy. However, outcomes for patients who underwent surgery were similar among Medicaid and uninsured patients. Additionally, patients with Medicaid and uninsured status had identical survival curves with regard to cancer-specific survival.