More Advanced Cancer in Medicaid Patients

Head and neck cancers diagnosed later and more fatal in Medicaid population

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Rates of cancers that develop in the head and neck are growing in the United States and around the world. In part, this increase can be blamed on the human papillomavirus.

A recent study looked at how low income individuals are treated for this disease.

Individuals who had Medicaid insurance were more likely to be diagnosed with more advanced head and neck cancers than people with private insurance. 

Race and age also played a role both in treatment and survival.

"If you have trouble swallowing, visit your doctor."

Sujha Subramanian, PhD, of RTI International in Waltham, Massachusetts, and Amy Chen, MD, of the Emory University School of Medicine in Atlanta, examined the treatment and survival of Medicaid patients with head and neck cancers.

The researchers analyzed 2002-2006 Medicaid claims linked with cancer registries in California and Georgia. Diagnosis, treatment and mortality were reviewed for 1,308 Medicaid beneficiaries between the ages 18 to 64 years.

“Prior studies have reported that Medicaid enrollees are more likely to be diagnosed as having late-stage cancers compared with those enrolled in private health plans. In addition, low-income men and women have significantly lower overall survival than those at higher socioeconomic status, even after controlling for stage of diagnosis,” the authors wrote.

This study confirmed these findings, showing the following:

  • Less than a third of the patients were diagnosed with early-stage head and neck cancers that are more treatable.
  • Almost a third of Medicaid patients died within 12 months of diagnosis.
  • Black patients were less likely to be treated with surgery and more likely to die than white Medicaid patients.
  • Death rates were higher among older individuals and those who were living with some sort of disability.
  • California residents who lived for at least a year after diagnosis were about 50 percent less likely to die within 24 months than Georgia residents.
  • People who did not receive surgery for tonsil cancer were 2.5 times more likely to die than those whose tonsils were removed.

The authors concluded that socioeconomic status seems to influence the incidence of these cancers for a variety of reasons, including lack of awareness about the cancers and lack of access to screening or early detection.

“Therefore, it is essential that steps are taken to educate this population on the symptoms of these cancers and emphasize the importance of dental checkups to improve early detection of head and neck cancer in this population,” the authors wrote.

This study, funded by National Institute of Dental and Craniofacial Research, was published April 18 in JAMA Otolaryngology-Head & Neck Surgery. No conflicts of interest were disclosed.

Reviewed by: 
Review Date: 
April 18, 2013
Last Updated:
December 10, 2013