Health Insurance Status Linked to Disparities in Pediatric Cancer Diagnosis


Pediatric patients who belong to racial/ethnic minority groups are more likely to be diagnosed with distant cancer, and this is partly related to health insurance coverage, according to research published in Cancer.

Prior studies have reported racial/ethnic disparities in the stage at cancer diagnosis among pediatric and adult patients. The aim of the current study was to evaluate whether access to health insurance was associated with disparities in pediatric cancer diagnoses.

“This information can help inform further research and targeted cancer control strategies to reduce the proportion of cancers diagnosed at an advanced stage,” the researchers wrote.


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The team evaluated data from 27,830 patients, age 19 and younger, who were diagnosed with cancer between 2007 and 2016. Patients with leukemia, myeloproliferative neoplasms, or myelodysplastic syndrome were not included.

A majority of patients (53%) were non-Hispanic White, 27.6% were Hispanic, 11.6% were non-Hispanic Black, and 7.9% were non-Hispanic Asian/Pacific Islander. 

In multivariable analyses, racial/ethnic minority patients were more likely to be diagnosed with distant cancer.

After adjustment for age, sex, and socioeconomic status, distant cancer diagnoses were more likely among non-Hispanic Black (prevalence ratio [PR], 1.31; 95% CI, 1.23-1.40), Hispanic (PR, 1.15; 95% CI, 1.09-1.21), and non-Hispanic Asian/Pacific Islander (PR, 1.14; 95% CI, 1.04-1.24) patients, compared with non-Hispanic White patients. 

When the data were adjusted for health insurance status as well, the PRs decreased to 1.24 (95% CI, 1.16-1.33) for non-Hispanic Black patients, 1.07 (95% CI, 1.01-1.13) for Hispanic patients, and 1.11 (95% CI, 1.02-1.21) for non-Hispanic Asian/Pacific Islander patients. 

Having Medicaid or no insurance at cancer diagnosis mediated 49% of the association with distant stage cancer for Hispanic patients, 22% for non-Hispanic Black patients, and 9% for Asian/Pacific Islander patients.

“Disparities in cancer diagnosis stage in racial/ethnic minority children and adolescents may be partially explained by health insurance coverage,” the researchers concluded. 

Reference

Wang X, Brown DS, Cao Y, et al. The impact of health insurance coverage on racial/ethnic disparities in US childhood and adolescent cancer stage at diagnosis. Cancer. Published online July 5, 2022. doi:10.1002/cncr.34368



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