Evidence map›Paper›PMID 33789522›Full record

ArticlePublic health reports (Washington, D.C. : 1974)

Health Insurance Status as a Predictor of Mode of Colon Cancer Detection but Not Stage at Diagnosis: Implications for Early Detection.

Lindsey A Jones, Katherine C Brewer, Leslie R Carnahan, Jennifer A Parsons, Blase N Polite, Carol Estwing Ferrans, Richard B Warnecke, Garth H Rauscher

Open access · bronzeAbstract read
In one paragraph

Article in Public health reports (Washington, D.C. : 1974). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.1field-weighted citation impact, top 56% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Lindsey A Jones14681 Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.ORCID 0000-0003-2799-7886
Katherine C Brewer14681 Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
Leslie R CarnahanDivision of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
Jennifer A ParsonsSurvey Research Laboratory, University of Illinois at Chicago, Chicago, IL, USA.ORCID 0000-0003-2968-6344
Blase N Polite2462 School of Medicine, University of Chicago, Chicago, IL, USA.
Carol Estwing FerransInstitute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.
Richard B WarneckeInstitute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.
Garth H Rauscher14681 Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
University of Illinois Chicago · USUniversity of Chicago · US

Funding

Research Training Education CoreP60MD003424 · NIMHD · UNIVERSITY OF ILLINOIS AT CHICAGO · PI FERRANS, CAROL E. · 2009 to 2013
$9.2M
NIMHD NIH HHS P60 MD003424
6 · The paper itself

Abstract

objectiveFor colon cancer patients, one goal of health insurance is to improve access to screening that leads to early detection, early-stage diagnosis, and polyp removal, all of which results in easier treatment and better outcomes. We examined associations among health insurance status, mode of detection (screen detection vs symptomatic presentation), and stage at diagnosis (early vs late) in a diverse sample of patients recently diagnosed with colon cancer from the Chicago metropolitan area.

methodsData came from the Colon Cancer Patterns of Care in Chicago study of racial and socioeconomic disparities in colon cancer screening, diagnosis, and care. We collected data from the medical records of non-Hispanic Black and non-Hispanic White patients aged ≥50 and diagnosed with colon cancer from October 2010 through January 2014 (N = 348). We used logistic regression with marginal standardization to model associations between health insurance status and study outcomes.

resultsAfter adjusting for age, race, sex, and socioeconomic status, being continuously insured 5 years before diagnosis and through diagnosis was associated with a 20 (95% CI, 8-33) percentage-point increase in prevalence of screen detection. Screen detection in turn was associated with a 15 (95% CI, 3-27) percentage-point increase in early-stage diagnosis; however, nearly half (47%; n = 54) of the 114 screen-detected patients were still diagnosed at late stage (stage 3 or 4). Health insurance status was not associated with earlier stage at diagnosis.

conclusionsFor health insurance to effectively shift stage at diagnosis, stronger associations are needed between health insurance and screening-related detection; between screening-related detection and early stage at diagnosis; or both. Findings also highlight the need to better understand factors contributing to late-stage colon cancer diagnosis despite screen detection.

Indexed as

Colonic NeoplasmsInsurance, HealthEarly Detection of CancerEthnicityHumansSocial Classcancercancer screeningcolon cancerhealth insurancestage at diagnosis

Identifiers

PMID33789522
PMCPMC9109539
OpenAlexW3148551637

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.