Association Between Primary Payer Status and Survival in Patients With Stage III Colon Cancer: An National Cancer Database Analysis

Aabra Ahmed, Ahmed Tahseen, Elizabeth England, Katrine Wolfe, Michael Simhachalam, Travis Homan, Jenna Sitenga, Ryan W. Walters, Peter T. Silberstein

Research output: Contribution to journalArticle

Abstract

Background: Colon cancer is the third most frequent cancer diagnosis, and primary payer status has been shown to be associated with treatment modalities and survival in cancer patients. The goal of our study was to determine the between-insurance differences in survival in patients with clinical stage III colon cancer using data from the National Cancer Database (NCDB). Materials and Methods: We identified 130,998 patients with clinical stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Kaplan-Meier curves and multivariable Cox regression models were used to determine the association between insurance status and survival. Results: Patients with private insurance plans were 28%, 30%, and 16% less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively. Medicare patients were 14% were less likely to die compared with uninsured patients. Patients receiving chemotherapy were, on average, 65% less likely to die compared with the patients not receiving chemotherapy. Conclusion: Private insurance and a greater socioeconomic status were associated with increased patient survival compared with other insurance plans or the lack of insurance. Future research should continue to unravel how socioeconomic status and insurance status contribute to the quality of care and survival of oncologic patients. The goal of our study was to determine the between-insurance differences in survival in patients with pathologic stage III colon cancer using data from the National Cancer Database (NCDB). We identified 130,998 patients with pathologic stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Patients with private insurance plans were 28%, 30%, and 16% less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively.

LanguageEnglish (US)
JournalClinical Colorectal Cancer
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Colonic Neoplasms
Databases
Survival
Insurance
Neoplasms
Medicare
Insurance Coverage
Medicaid
Social Class
Drug Therapy
Quality of Health Care
Proportional Hazards Models

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology

Cite this

Association Between Primary Payer Status and Survival in Patients With Stage III Colon Cancer : An National Cancer Database Analysis. / Ahmed, Aabra; Tahseen, Ahmed; England, Elizabeth; Wolfe, Katrine; Simhachalam, Michael; Homan, Travis; Sitenga, Jenna; Walters, Ryan W.; Silberstein, Peter T.

In: Clinical Colorectal Cancer, 01.01.2018.

Research output: Contribution to journalArticle

Ahmed, Aabra ; Tahseen, Ahmed ; England, Elizabeth ; Wolfe, Katrine ; Simhachalam, Michael ; Homan, Travis ; Sitenga, Jenna ; Walters, Ryan W. ; Silberstein, Peter T. / Association Between Primary Payer Status and Survival in Patients With Stage III Colon Cancer : An National Cancer Database Analysis. In: Clinical Colorectal Cancer. 2018.
@article{d7dd9c000a804bc4886b56e5a353bf25,
title = "Association Between Primary Payer Status and Survival in Patients With Stage III Colon Cancer: An National Cancer Database Analysis",
abstract = "Background: Colon cancer is the third most frequent cancer diagnosis, and primary payer status has been shown to be associated with treatment modalities and survival in cancer patients. The goal of our study was to determine the between-insurance differences in survival in patients with clinical stage III colon cancer using data from the National Cancer Database (NCDB). Materials and Methods: We identified 130,998 patients with clinical stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Kaplan-Meier curves and multivariable Cox regression models were used to determine the association between insurance status and survival. Results: Patients with private insurance plans were 28{\%}, 30{\%}, and 16{\%} less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively. Medicare patients were 14{\%} were less likely to die compared with uninsured patients. Patients receiving chemotherapy were, on average, 65{\%} less likely to die compared with the patients not receiving chemotherapy. Conclusion: Private insurance and a greater socioeconomic status were associated with increased patient survival compared with other insurance plans or the lack of insurance. Future research should continue to unravel how socioeconomic status and insurance status contribute to the quality of care and survival of oncologic patients. The goal of our study was to determine the between-insurance differences in survival in patients with pathologic stage III colon cancer using data from the National Cancer Database (NCDB). We identified 130,998 patients with pathologic stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Patients with private insurance plans were 28{\%}, 30{\%}, and 16{\%} less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively.",
author = "Aabra Ahmed and Ahmed Tahseen and Elizabeth England and Katrine Wolfe and Michael Simhachalam and Travis Homan and Jenna Sitenga and Walters, {Ryan W.} and Silberstein, {Peter T.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.clcc.2018.09.004",
language = "English (US)",
journal = "Clinical Colorectal Cancer",
issn = "1533-0028",
publisher = "Elsevier",

}

TY - JOUR

T1 - Association Between Primary Payer Status and Survival in Patients With Stage III Colon Cancer

T2 - Clinical Colorectal Cancer

AU - Ahmed, Aabra

AU - Tahseen, Ahmed

AU - England, Elizabeth

AU - Wolfe, Katrine

AU - Simhachalam, Michael

AU - Homan, Travis

AU - Sitenga, Jenna

AU - Walters, Ryan W.

AU - Silberstein, Peter T.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Colon cancer is the third most frequent cancer diagnosis, and primary payer status has been shown to be associated with treatment modalities and survival in cancer patients. The goal of our study was to determine the between-insurance differences in survival in patients with clinical stage III colon cancer using data from the National Cancer Database (NCDB). Materials and Methods: We identified 130,998 patients with clinical stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Kaplan-Meier curves and multivariable Cox regression models were used to determine the association between insurance status and survival. Results: Patients with private insurance plans were 28%, 30%, and 16% less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively. Medicare patients were 14% were less likely to die compared with uninsured patients. Patients receiving chemotherapy were, on average, 65% less likely to die compared with the patients not receiving chemotherapy. Conclusion: Private insurance and a greater socioeconomic status were associated with increased patient survival compared with other insurance plans or the lack of insurance. Future research should continue to unravel how socioeconomic status and insurance status contribute to the quality of care and survival of oncologic patients. The goal of our study was to determine the between-insurance differences in survival in patients with pathologic stage III colon cancer using data from the National Cancer Database (NCDB). We identified 130,998 patients with pathologic stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Patients with private insurance plans were 28%, 30%, and 16% less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively.

AB - Background: Colon cancer is the third most frequent cancer diagnosis, and primary payer status has been shown to be associated with treatment modalities and survival in cancer patients. The goal of our study was to determine the between-insurance differences in survival in patients with clinical stage III colon cancer using data from the National Cancer Database (NCDB). Materials and Methods: We identified 130,998 patients with clinical stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Kaplan-Meier curves and multivariable Cox regression models were used to determine the association between insurance status and survival. Results: Patients with private insurance plans were 28%, 30%, and 16% less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively. Medicare patients were 14% were less likely to die compared with uninsured patients. Patients receiving chemotherapy were, on average, 65% less likely to die compared with the patients not receiving chemotherapy. Conclusion: Private insurance and a greater socioeconomic status were associated with increased patient survival compared with other insurance plans or the lack of insurance. Future research should continue to unravel how socioeconomic status and insurance status contribute to the quality of care and survival of oncologic patients. The goal of our study was to determine the between-insurance differences in survival in patients with pathologic stage III colon cancer using data from the National Cancer Database (NCDB). We identified 130,998 patients with pathologic stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Patients with private insurance plans were 28%, 30%, and 16% less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively.

UR - http://www.scopus.com/inward/record.url?scp=85054509810&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054509810&partnerID=8YFLogxK

U2 - 10.1016/j.clcc.2018.09.004

DO - 10.1016/j.clcc.2018.09.004

M3 - Article

JO - Clinical Colorectal Cancer

JF - Clinical Colorectal Cancer

SN - 1533-0028

ER -