ArticleGynecologic oncology2016
Disparities in the management and outcome of cervical cancer in the United States according to health insurance status.
Article in Gynecologic oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Disparities in Surgical Access: A Systematic Literature Review, Conceptual Model, and Evidence Map.Journal of the American College of Surgeons · 2019Pooled it
- Incidence and risk factors of postoperative delirium in children with congenital heart disease.PloS one · 2026Article
- Embracing and implementing the WHO cervical cancer elimination campaign goals: A consensus statement by SGO, ACOG, ASCCP, ASTRO, and ABS on minimum quality care standards for cervical cancer patients in the U.S.Gynecologic oncology · 2025Article
- The Impact of Split Radiation Therapy on the Management of Locally Advanced Cervical Cancer in Central Virginia.Cureus · 2025Article
- Racial disparities in receipt of radiation and brachytherapy in cervical cancer patients: Do they exist in a SEER-Medicare population?Gynecologic oncology reports · 2024Article
- Survival disparities in non-Hispanic Black and White cervical cancer patients vary by histology and are largely explained by modifiable factors.Gynecologic oncology · 2024Article
- Mediation of Racial and Ethnic Inequities in the Diagnosis of Advanced-Stage Cervical Cancer by Insurance Status.JAMA network open · 2023Article
- Article
- Healthcare Disparities in Gynecologic Oncology.Advances in oncology · 2022Article
- Patient perspectives on cervical cancer screening interventions among underscreened women.PloS one · 2022Article
- Association of Medicaid expansion and insurance status, cancer stage, treatment and mortality among patients with cervical cancer.Cancer reports (Hoboken, N.J.) · 2021Article
- Effects of insurance status on long-term survival among non-small cell lung cancer (NSCLC) patients in Beijing, China: A population-based study.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2020Article
- The Impact of Insurance and Marital Status on Survival in Patients with Nasopharyngeal Carcinoma.Biology · 2020Article
- Cervical cancer outcome by type of health care facilities: National Cancer Database, 2004-2015.Cancer health disparities · 2020Article
- Disparities Among Cervical Cancer Patients Receiving Brachytherapy.Obstetrics and gynecology · 2019Article
- Article
- Definitive radiation therapy for cervical cancer: Non-white race and public insurance are risk factors for delayed completion, a pilot study.Gynecologic oncology reports · 2018Article
- Insurance status and cancer treatment mediate the association between race/ethnicity and cervical cancer survival.PloS one · 2018Article
- Recent trends in racial and regional disparities in cervical cancer incidence and mortality in United States.PloS one · 2017Article
- Comparison of Secular Trends in Cervical Cancer Mortality in China and the United States: An Age-Period-Cohort Analysis.International journal of environmental research and public health · 2016Article
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9 authors.
Funding
Abstract
introductionOur study sought to characterize the presentation, local management and outcomes of invasive cervical cancer with regard to patient insurance status.
methodsWe queried the NCI-SEER database for invasive cervical cancer cases in patients aged 18-64 from 2007 to 2011. We analyzed clinical and socioeconomic data with regard insurance status (insured, Medicaid, or uninsured). We tested for associations between patient insurance status and treatment with definitive surgery for FIGO IA2-IB1 patients, and treatment with suboptimal radiation therapy (RT) for FIGO IB2-IVA patients (other than combination external beam and brachytherapy). We evaluated overall and cause specific survival according to insurance status.
results11,714 cases were analyzed: 60% insured, 31% Medicaid, and 9% uninsured. FIGO III/IV stage at presentation was more frequent with Medicaid (40%) and uninsured (42%) compared to insured patients (28%) (p<0.001). For FIGO IA2-IB1 patients, receipt of definitive surgery was inversely associated with uninsured status (OR [95%CI]=0.65 [0.47-0.90], p<0.001) in univariable analysis; however the relationship lost significance after multivariable adjustment. For FIGO IB2-IVA patients, the use of suboptimal RT was associated with uninsured status (OR [95%CI]=1.33 [1.07-1.65], p=0.011) in adjusted analyses. Among all patients, overall mortality was increased with Medicaid (HR [95%CI]=1.16 [1.05-1.28], p=0.003) and uninsured status (HR [95%CI]=1.17 [1.01-1.34], p=0.031) in multivariable analysis. Cancer specific mortality survival trended towards significance in multivariable analyses for both Medicaid (HR [95%CI]=1.11 [1.00-1.24] and uninsured status (HR [95%CI]=1.14 [0.98-1.33]).
conclusionsDisparities in cervical cancer treatment with regard to insurance status are apparent in a recent cohort of American patients. Later stage at presentation and differences in management partially account for the inferior prognostic outcomes associated with Medicaid and uninsured status.
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