ArticleCancer2021
Relationship between insurance status and outcomes for patients with breast cancer in Missouri.
Article in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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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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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
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Association of insurance status among cancer patients and survival outcomes: a systematic review and meta-analysis.International journal for equity in health · 2025Pooled it
- Biomarker, treatment patterns, and survival differences in metastatic triple-negative breast cancer by race in the United States.NPJ breast cancer · 2026Article
- Disparities in Disease Presentation and Treatment Initiation for De Novo Metastatic Breast Cancer.JAMA network open · 2026Article
- Impact of Medicaid Enrollment Timing on Tumor Stage at Diagnosis and Survival in Breast, Colorectal, and Lung Cancer.Healthcare (Basel, Switzerland) · 2026Article
- Use of Complementary and Alternative Medicine in the Management of Breast Cancer.JAMA network open · 2026Article
- Comparison of Survival Outcomes Among Women With Breast Cancer Across Different Health Systems in Veracruz, Mexico.Cureus · 2026Article
- The impact of anxiety and affective disorders on breast cancer screening in women in Puerto Rico.PloS one · 2026Article
- Impact of Socioeconomic Factors on Surgical Approach and Outcomes in Young Women with Breast Cancer.European journal of breast health · 2025Article
- Racial and ethnic disparities in neoadjuvant chemotherapy patterns and outcomes in early-stage HER2-positive breast cancer.NPJ breast cancer · 2025Article
- Geographic Access to Cancer Care and Breast Cancer Treatment in Low-Income Women.Medical care · 2025Article
- Residential proximity to national priorities list superfund sites is associated with increased likelihood of metastatic breast cancer presentation.Scientific reports · 2025Article
- Time-to-Treatment Initiation and Its Effect on All-Cause Mortality: Insights From the Surveillance, Epidemiology, and End Results Database.World journal of oncology · 2025Article
- Sociodemographic Disparities in Rectal Cancer Outcomes within Academic Cancer Centers.Annals of surgical oncology · 2025Article
- Factors associated with locoregional recurrence after neoadjuvant chemotherapy for breast cancer in a safety-net medical center.Breast cancer research and treatment · 2025Article
- An innovative approach to the multidisciplinary treatment of uninsured breast cancer patients.Cancer causes & control : CCC · 2025Article
- Breast Radiation Therapy Survivorship and Cancer Support Groups: an Opportunity for Community Engagement and Education Through the Addressing Breast Cancer Dermatologic Side Effects (ABCDEs) Program.Journal of cancer education : the official journal of the American Association for Cancer Education · 2025Article
- Impact of Structural Racism and Social Determinants of Health on Disparities in Breast Cancer Mortality.Cancer research · 2024Review
- Patient-reported observations on medical procedure timeliness (PROMPT) in breast cancer: a qualitative study.Breast cancer research and treatment · 2024Article
- Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured.Cancer medicine · 2024Article
- Preexisting Diabetes and Breast Cancer Treatment Among Low-Income Women.JAMA network open · 2024Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe cancer stage at diagnosis, treatment delays, and breast cancer mortality vary with insurance status.
methodsUsing the Missouri Cancer Registry, this analysis included 31,485 women diagnosed with invasive breast cancer from January 1, 2007, to December 31, 2015. Odds ratios (ORs) of a late-stage (stage III or IV) diagnosis and a treatment delay (>60 days after the diagnosis) were calculated with logistic regression. The hazard ratio (HR) of breast cancer mortality was calculated with Cox proportional hazards regression. Mediation analysis was used to quantify the individual contributions of each covariate to mortality.
resultsThe OR of a late-stage diagnosis was higher for patients with Medicaid (OR, 1.72; 95% confidence interval [CI], 1.56-1.91) or no insurance (OR, 2.30; 95% CI, 1.91-2.78) in comparison with privately insured patients. Medicare (OR, 1.21; 95% CI, 1.10-1.37), Medicaid (OR, 1.60; 95% CI, 1.37-1.85), and uninsured patients (OR, 1.58; 95% CI, 1.18-2.12) had higher odds of a treatment delay. The HR of breast cancer-specific mortality was significantly increased in the groups with public insurance or no insurance and decreased after sequential adjustments for sociodemographic factors (HR, 2.39; 95% CI, 1.96-2.91), tumor characteristics (HR, 1.28; 95% CI, 1.05-1.56), and treatment (HR, 1.23; 95% CI, 1.01-1.50). Late-stage diagnoses accounted for 72.5% of breast cancer mortality in the uninsured.
conclusionsCompared with the privately insured, women with public or no insurance had a higher risk for advanced breast cancer, a >60-day treatment delay, and death from breast cancer. Particularly for the uninsured, Medicaid expansion and increased funding for education and screening programs could decrease breast cancer disparities.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.