ArticleBMC cancer2015
Effects of payer status on breast cancer survival: a retrospective study.
Article in BMC cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
25 citing papers in PubMed.
- The Efficacy of Direct Mail, Patient Navigation, and Incentives for Increasing Mammography and Colonoscopy in the Medicaid Population: A Randomized Controlled Trial.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2018Trial
- Association of the Affordable Care Act With Receipt of Guideline-Concordant Adjuvant Chemotherapy for Colon and Non-Small Cell Lung Cancer.Cancer medicine · 2026Article
- Impact of Socioeconomic Factors on Surgical Approach and Outcomes in Young Women with Breast Cancer.European journal of breast health · 2025Article
- Receipt of guideline-concordant care and survival among young adult women with non-metastatic breast cancer.Breast cancer research and treatment · 2025Article
- Geospatial Hot Spots and Cold Spots in US Cancer Disparities and Associated Risk Factors, 2004-2008 to 2014-2018.Preventing chronic disease · 2024Article
- AI Survival Prediction Modeling: The Importance of Considering Treatments and Changes in Health Status over Time.Cancers · 2024Article
- Effect of neighborhood and individual-level socioeconomic factors on breast cancer screening adherence in a multi-ethnic study.BMC public health · 2024Article
- Disparities in stage at diagnosis among breast cancer molecular subtypes in China.Cancer medicine · 2023Article
- Hispanic Ethnicity and Breast Cancer: Disaggregating Surgical Management and Mortality by Race.Journal of racial and ethnic health disparities · 2022Article
- Is Medicaid Expansion Narrowing Gaps in Surgical Disparities for Low-Income Breast Cancer Patients?Annals of surgical oncology · 2022Article
- Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Breast Invasive Ductal Carcinoma Patients After Surgery: A Large Population-Based Study.Frontiers in surgery · 2022Article
- Socioeconomic and Surgical Disparities are Associated with Rapid Relapse in Patients with Triple-Negative Breast Cancer.Annals of surgical oncology · 2021Article
- The role of education on Cancer amenable mortality among non-Hispanic blacks & non-Hispanic whites in the United States (1989-2018).BMC cancer · 2021Article
- Propensity Score Matching Analysis of the Effect of Payer Status on the Survival of Colon Cancer Patients.Cureus · 2021Article
- Article
- Impact of insurance and neighborhood socioeconomic status on clinical outcomes in therapeutic clinical trials for breast cancer.Cancer medicine · 2021Article
- Literature review of data-based models for identification of factors associated with racial disparities in breast cancer mortality.Health systems (Basingstoke, England) · 2019Review
- Breast Cancer Incidence by Stage Before and After Change in Screening Guidelines.American journal of preventive medicine · 2019Article
- Medical costs of treating breast cancer among younger Medicaid beneficiaries by stage at diagnosis.Breast cancer research and treatment · 2017Article
- The quality of invasive breast cancer care for low reimbursement rate patients: A retrospective study.PloS one · 2017Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBreast cancer outcomes are influenced by multiple factors including access to care, and payer status is a recognized barrier to treatment access. To further define the influence of payer status on outcome, the National Cancer Data Base data from 1998-2006 was analyzed.
methodData was analyzed from 976,178 female patients diagnosed with breast cancer registered in the National Cancer Data Base. Overall survival was the primary outcome variable while payer status was the primary predictor variable. Secondary predictor variables included stage, age, race, Charlson Comorbidity index, income, education, distance travelled, cancer program, diagnosing/treating facility, and treatment delay. Multivariate Cox regression was used to investigate the effect of payer status on overall survival while adjusting for secondary predictive factors.
resultsUninsured (28.68%) and Medicaid (28.0%) patients had a higher percentage of patients presenting with stage III and stage IV cancer at diagnosis. In multivariate analysis, after adjusting for secondary predictor variables, payer status was a statistically significant predictor of survival. Patients with private, unknown, or Medicare status showed a decreased risk of dying compared to uninsured, with a decrease of 36%, 22%, and 15% respectively. However, Medicaid patients had an increased risk of 11% compared to uninsured. The direct adjusted median overall survival was 14.92, 14.76, 14.56, 13.64, and 12.84 years for payer status of private, unknown, Medicare, uninsured, and Medicaid respectively.
conclusionWe observed that patients with no insurance or Medicaid were most likely to be diagnosed at stage III and IV. Payer status showed a statistically significant relationship with overall survival. This remained true after adjusting for other predictive factors. Patients with no insurance or Medicaid had higher mortality.
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