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Modifiable Factors Tied to Mortality Hike in Rectal Cancer

Cancer stage, treatment disparities largely account for poorer survival in patients with no insurance, Medicaid

MONDAY, June 14 (HealthDay News) -- Disparities in cancer stage and treatment account for most of the excess mortality in rectal cancer patients who are uninsured or on Medicaid, compared with privately insured patients, according to research published online June 14 in Cancer.

Anthony S. Robbins, M.D., of the American Cancer Society in Atlanta, and colleagues examined data on 19,154 rectal cancer patients aged 18 to 64 to determine the impact of 10 demographic, clinical and other factors, as well as insurance status on five-year survival.

After adjusting for age only, the researchers found that patients with Medicaid or no insurance were twice as likely to die within five years of treatment as those with private insurance (hazard ratios, 2.05 and 2.01, respectively). Excess mortality for Medicaid recipients and uninsured patients dropped after adjustment for all factors other than stage and treatment, to hazard ratios of 1.88 and 1.84, respectively; and, the hazard ratios were 1.34 and 1.29, respectively, after adjustment for stage and treatment.

"After adjustment for age, further adjustment for nine other factors reduced the excess mortality among rectal cancer patients without private insurance by approximately 70 percent. Disparities in stage and treatment accounted for approximately 53 percent of the excess mortality, whereas factors other than stage and treatment accounted for approximately 17 percent," the authors write.

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