ArticleJAMA network open2020
Association of Medicaid Insurance With Survival Among Patients With Small Cell Lung Cancer.
Article in JAMA network open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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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
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association of insurance status among cancer patients and survival outcomes: a systematic review and meta-analysis.International journal for equity in health · 2025Pooled it
- Medicaid Expansion and Overall Mortality Among Individuals With Renal Cell Carcinoma.The Journal of surgical research · 2026Article
- Utilization of cancer-directed surgical therapy in Medicaid patients with cancer: comparison between low/intermediate/high-risk surgeries.Cancer causes & control : CCC · 2025Article
- Delays in phases of care from identification to treatment of suspicious lung nodules.JTCVS open · 2025Article
- Impact of Medicaid expansion under the Patient Protection and Affordable Care Act on lung cancer care in the US.Journal of thoracic disease · 2024Article
- Influence of Health Insurance Types on Clinical Cancer Care Accessibility and Quality UsingMedicina (Kaunas, Lithuania) · 2024Article
- Review
- Understanding inequities in precision oncology diagnostics.Nature cancer · 2023Review
- Small cell lung cancer in young patients: trends in sociodemographic factors, diagnosis, treatment, and survival.Journal of thoracic disease · 2022Article
- Role of Medicaid in Early Detection of Screening-Amenable Cancers.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
- Association of Medicaid expansion and insurance status, cancer stage, treatment and mortality among patients with cervical cancer.Cancer reports (Hoboken, N.J.) · 2021Article
- Association of Race, Socioeconomic Factors, and Treatment Characteristics With Overall Survival in Patients With Limited-Stage Small Cell Lung Cancer.JAMA network open · 2021Article
- Racial and Other Healthcare Disparities in Patients With Extensive-Stage SCLC.JTO clinical and research reports · 2021Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
Importance: Small cell lung cancer (SCLC) is an aggressive neoplasm requiring rapid access to subspecialized multidisciplinary care. For this reason, insurance coverage such as Medicaid may be associated with oncologic outcomes in this disproportionately economically vulnerable population. With Medicaid expansion under the Affordable Care Act, it is important to understand outcomes associated with Medicaid coverage among patients with SCLC. Objective: To determine the association of Medicaid coverage with survival compared with other insurance statuses. Design, Setting, and Participants: This cohort study included adult patients with limited-stage (LS) and extensive-stage (ES) SCLC in the US National Cancer Database from 2004 to 2013. Data were analyzed in January 2019. Main Outcomes and Measures: Patients were analyzed with respect to insurance status. Associations of insurance status with survival were interrogated with univariate analyses, multivariable analyses, and propensity score matching. Results: A total of 181 784 patients with SCLC (93 131 [51.2%] female; median [interquartile range] age; 67 [60-75] years for patients with LS-SCLC and 68 [60-75] years for patients with ES-SCLC) were identified, of whom 70 247 (38.6%) had LS-SCLC and 109 479 (60.2%) had ES-SCLC. On univariate analyses of patients with LS-SCLC, Medicaid coverage was not associated with a survival advantage compared with being uninsured (hazard ratio, 1.02; 95% CI, 0.96-1.08; P = .49). Likewise, on multivariable analyses of patients with ES-SCLC, compared with being uninsured, Medicaid coverage was not associated with a survival advantage (hazard ratio, 1.00; 95% CI, 0.96-1.03; P = .78). After propensity score matching, median survival was similar between the uninsured and Medicaid groups both among patients with LS-SCLC (14.4 vs 14.1 months; hazard ratio, 1.05; 95% CI, 0.98-1.12; P = .17) and those with ES-SCLC (6.3 vs 6.4 months; hazard ratio, 1.00; 95% CI, 0.96-1.04; P = .92). Conclusions and Relevance: Despite of billions of dollars in annual federal and state spending, Medicaid was not associated with improved survival in patients with SCLC compared with being uninsured in the US National Cancer Database. These findings suggest that there are substantial outcome inequalities for SCLC relevant to the policy debate on the Medicaid expansion under the Affordable Care Act.
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