Insurance status is strongly associated with disease severity among prostate cancer patients, researchers from the American Cancer Society recently reported.
Insurance status is strongly associated with disease severity among prostate cancer patients, researchers from the American Cancer Society recently reported.
The study, which was published in Cancer Epidemiology Biomarkers and Prevention (2010; 19:2437-44), finds that men who were uninsured or Medicaid-insured at the time of diagnosis had significantly higher PSA levels, clinical T stage, and Gleason scores than men with private insurance. Greater disease severity among men who are uninsured or Medicaid-insured likely reflects lower access to medical care and utilization of PSA testing and a higher proportion of non screen-detected cancers, the study authors say.
The researchers, led by epidemiologist Stacey A. Fedewa, MPH, analyzed data from 312,339 prostate cancer patients diagnosed between 2004 and 2006 in the National Cancer Database. The study found uninsured and Medicaid-insured patients’ PSA levels were approximately 4.0 ng/mL higher than those of privately insured patients after adjusting for age, race, comorbidity, and area level socioeconomic status.
Men who were uninsured or Medicaid-insured were also more likely to have the highest Gleason score (OR=1.97 95% CI: 1.82-2.12 and OR=1.67 95% CI: 1.55-1.79, respectively). Finally, the uninsured and Medicaid-insured were more likely to be diagnosed with advanced disease (OR=1.85, 95% CI: 1.69-2.03 and OR=1.49, 95% CI: 1.35-1.63, respectively).
"Strong associations between insurance and disease severity are likely to be related to lack of access to preventive services such as PSA screening and barriers to timely medical evaluation of urologic symptoms," the authors wrote. "Although there are unresolved questions about risks and benefits of PSA screening, it is important that all men have the opportunity to be informed about this option as well as access to other preventative health services and primary care."
Enzalutamide granted approval in EU for nmHSPC
April 24th 2024The approval is supported by data from the phase 3 EMBARK trial, which demonstrated that enzalutamide with or without leuprolide prolonged metastasis-free survival compared with leuprolide alone in patients with high-risk biochemically recurrent nmHSPC.
Experts develop guide on online tools to reduce costs of urologic drugs
April 22nd 2024"At a time when patients are increasingly concerned about prescription drugs, this information will provide a useful starting point for making essential medications as affordable as possible," says Ruchika Talwar, MD.