Parichoy Pal Choudhury, Helmneh M Sineshaw, Rachel A Freedman, Michael T Halpern, Leticia Nogueira, Ahmedin Jemal, Farhad Islami
{"title":"Contribution of health insurance to racial and ethnic disparities in advanced stage diagnosis of 10 cancers.","authors":"Parichoy Pal Choudhury, Helmneh M Sineshaw, Rachel A Freedman, Michael T Halpern, Leticia Nogueira, Ahmedin Jemal, Farhad Islami","doi":"10.1093/jnci/djae242","DOIUrl":null,"url":null,"abstract":"<p><p>For many cancer sites, it is unclear to what extent differences in health insurance coverage contribute to racial and ethnic disparities in stage III-IV diagnoses. Using the National Cancer Database (1,893,026 patients aged 18-64 years, diagnosed between 2013-2019), we investigated a potential mediating role of health insurance (privately insured vs uninsured) in explaining racial and ethnic disparities in stage at diagnosis of 10 cancers (ie, breast, prostate, colorectal, lung, cervical, uterine, bladder, head and neck, skin melanoma), detectable early through screening, physical examination, or clinical symptoms. The analyses provided evidence of mediation of non-Hispanic Black vs White disparities in eight cancers (range of proportions mediated: 4.5%-29.1%); Hispanic vs non-Hispanic White disparities in six cancers (13.2%-68.8%); non-Hispanic Asian/Pacific Islander vs White disparities in three cancers (5.8%-11.3%). To summarize, health insurance accounts for a significant proportion of the racial and ethnic disparities in stage III-IV diagnoses across a wide range of cancers.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":null,"pages":null},"PeriodicalIF":9.9000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JNCI Journal of the National Cancer Institute","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jnci/djae242","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
For many cancer sites, it is unclear to what extent differences in health insurance coverage contribute to racial and ethnic disparities in stage III-IV diagnoses. Using the National Cancer Database (1,893,026 patients aged 18-64 years, diagnosed between 2013-2019), we investigated a potential mediating role of health insurance (privately insured vs uninsured) in explaining racial and ethnic disparities in stage at diagnosis of 10 cancers (ie, breast, prostate, colorectal, lung, cervical, uterine, bladder, head and neck, skin melanoma), detectable early through screening, physical examination, or clinical symptoms. The analyses provided evidence of mediation of non-Hispanic Black vs White disparities in eight cancers (range of proportions mediated: 4.5%-29.1%); Hispanic vs non-Hispanic White disparities in six cancers (13.2%-68.8%); non-Hispanic Asian/Pacific Islander vs White disparities in three cancers (5.8%-11.3%). To summarize, health insurance accounts for a significant proportion of the racial and ethnic disparities in stage III-IV diagnoses across a wide range of cancers.
期刊介绍:
The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.