Evidence map›Paper›PMID 41074060›Full record

SynthesisInternational journal for equity in health2025

Association of insurance status among cancer patients and survival outcomes: a systematic review and meta-analysis.

Jiashuai Tian, Jiayang Kong, Na Zhou, Liliang Zhang, Xinyu Cai, Dai Su, Guangying Gao

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal for equity in health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

7 authors.

Jiashuai TianSchool of Public Health, Capital Medical University, No. 10, Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China.
Jiayang KongSchool of Psychology, Shannxi Normal University, Xian, 710062, China.
Na ZhouDepartment of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
Liliang ZhangSchool of Public Health, Capital Medical University, No. 10, Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China.
Xinyu CaiSchool of Public Health, Capital Medical University, No. 10, Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China.
Dai SuSchool of Public Health, Capital Medical University, No. 10, Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China.
Guangying GaoSchool of Public Health, Capital Medical University, No. 10, Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China. gaogy@ccmu.edu.cn.

Funding

China Health Economics Association 2024SK001192
6 · The paper itself

Abstract

introductionHealth insurance coverage is a critical determinant of cancer care access. However, the association of different insurance statuses affecting survival outcomes remains understudied worldwide. This meta-analysis provides global evidence on the association between insurance status and survival and highlights structural health inequities across national health insurance systems.

methodsWe searched five databases for cohort studies published between 1 January 2000 and 15 July 2025. Random-effect multilevel and traditional meta-analyses were employed to address heterogeneity. The Newcastle-Ottawa Scale (NOS) and the ROBINS-I method assessed all studies for quality.

resultsWe included 37 studies between 2000 and 2025, contributing 219 effect sizes. In the United States (US), patients insured in Medicare (HR: 1.29, 95% CI: 1.17-1.42, P < 0.001; τ

conclusionsThe association between insurance status and cancer survival differs across national health insurance systems. Insurance policies should prioritize early-stage cancer care, cancer types with a favorable prognosis, and uninsured groups. Future research should use prospective international cohorts to explore how insurance structures and covariate interactions affect survival and to achieve equity in global cancer care.

Indexed as

Insurance CoverageInsurance, HealthNeoplasmsHealth Services AccessibilityHumansMedicaidMedicareSurvival AnalysisUnited StatesCancer health disparitiesInsurance statusSurvival outcomesSystematic review

Identifiers

PMID41074060
PMCPMC12512495

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.