ArticleCancer medicine2020
Insurance impacts survival for children, adolescents, and young adults with bone and soft tissue sarcomas.
Article in Cancer medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Systematic Review of Health Insurance and Survival Among Adolescent and Young Adult Cancer Patients.Journal of adolescent and young adult oncology · 2026Pooled it
- Barriers to care for musculoskeletal sarcoma patients: a public health perspective.Frontiers in public health · 2024Pooled it
- Social determinants of health and pediatric cancer survival: A systematic review.Pediatric blood & cancer · 2022Pooled it
- Adolescents and young adults with cancers: comparative analyses of incidence and survival between Europe and the United States.ESMO real world data and digital oncology · 2026Article
- Health Insurance as a Mediator of Neighborhood Deprivation and Pediatric Cancer Survival: An Analysis of State Cancer Registry Data.Cancer medicine · 2026Article
- Area Deprivation and Pediatric Cancer Mortality: An Analysis of 2000 to 2020 State Cancer Registry Data.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Survivorship Considerations and Management in the Adolescent and Young Adult Sarcoma Population: A Review.Current oncology (Toronto, Ont.) · 2025Review
- Observational
- Poverty, race, ethnicity, and survival in pediatric nonmetastatic osteosarcoma: a Children's Oncology Group report.Journal of the National Cancer Institute · 2024Article
- Racial disparities in the management and outcomes of primary osseous neoplasms of the spine: a SEER analysis.Journal of neuro-oncology · 2024Article
- Racial and survival disparities in inflammatory breast cancer (IBC) and non-IBC: a population-based study focused on Native Hawaiians and other Pacific Islanders.Frontiers in oncology · 2024Article
- Medicare Advantage in Soft Tissue Sarcoma May Be Associated with Worse Patient Outcomes.Journal of clinical medicine · 2023Article
- Access to Chimeric Antigen Receptor T Cell Clinical Trials in Underrepresented Populations: A Multicenter Cohort Study of Pediatric and Young Adult Acute Lymphobastic Leukemia Patients.Transplantation and cellular therapy · 2023Article
- Pilot Study in Investigating Material Financial Toxicity Markers by Age in Cancer Patients.Journal of adolescent and young adult oncology · 2023Article
- Population-Based Impact of Rurality and Neighborhood-Level Socioeconomic Disadvantage on Pediatric Cancer Mortality in Washington State.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- Soft-tissue Sarcoma Survival in the US Military Health System: Comparison With the SEER Program.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2022Article
- Clinical characteristics and outcomes of infants compared with children diagnosed with rhabdomyosarcoma: Analysis of surveillance, epidemiology and end results data from 2000 to 2016.Cancer reports (Hoboken, N.J.) · 2022Article
- Socioeconomic disparities in survival after high-risk neuroblastoma treatment with modern therapy.Pediatric blood & cancer · 2021Article
- Poor-Prognosis Metastatic Cancers in Adolescents and Young Adults: Incidence Patterns, Trends, and Disparities.JNCI cancer spectrum · 2021Article
- Poverty and Survival in Childhood Cancer: A Framework to Move Toward Systemic Change.Journal of the National Cancer Institute · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundWhile racial/ethnic survival disparities have been described in pediatric oncology, the impact of income has not been extensively explored. We analyzed how public insurance influences 5-year overall survival (OS) in young patients with sarcomas.
methodsThe University of California San Francisco Cancer Registry was used to identify patients aged 0-39 diagnosed with bone or soft tissue sarcomas between 2000 and 2015. Low-income patients were defined as those with no insurance or Medicaid, a means-tested form of public insurance. Survival curves were computed using the Kaplan-Meier method and compared using log-rank tests and Cox models. Causal mediation was used to assess whether the association between public insurance and mortality is mediated by metastatic disease.
resultsOf 1106 patients, 39% patients were classified as low-income. Low-income patients were more likely to be racial/ethnic minorities and to present with metastatic disease (OR 1.96, 95% CI 1.35-2.86). Low-income patients had significantly worse OS (61% vs 71%). Age at diagnosis and extent of disease at diagnosis were also independent predictors of OS. When stratified by extent of disease, low-income patients consistently had significantly worse OS (localized: 78% vs 84%, regional: 64% vs 73%, metastatic: 23% vs 30%, respectively). Mediation analysis indicated that metastatic disease at diagnosis mediated 15% of the effect of public insurance on OS.
conclusionsLow-income patients with bone and soft tissue sarcomas had decreased OS regardless of disease stage at presentation. The mechanism by which insurance status impacts survival requires additional investigation, but may be through reduced access to care.
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Registered trials
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