ATLANTA - Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling health care obstacles.
People without health insurance are less likely to get recommended cancer screening tests, the study also found, confirming earlier research. And when these patients finally do get diagnosed, their cancer is likely to have spread.
The research by scientists with the American Cancer Society offers important context for the national discussion about health care reform, experts say - even though the uninsured are believed to account for just a fraction of US cancer deaths. An Associated Press analysis suggests it is around 4 percent.
Those dealing with cancer and inadequate insurance weren't surprised by the findings.
"I would just like for something to be done to help someone else, so they don't have to go through what we went through," said Peggy Hicks, a Florida woman whose husband died in August from colon cancer.
Edward Hicks was uninsured, and a patchwork health care system delayed him from getting chemotherapy that some argue might have extended his life.
"He was so ill. And you're trying to get him help and you can't, you can't," said his 67-year-old widow.
The new research is being published in CA: A Cancer Journal for Clinicians, a cancer society publication. In an accompanying editorial, the society's president repeated the organization's call for action to fix holes in the health care safety net.
"The truth is that our national reluctance to face these facts is condemning thousands of people to die from cancer each year," Dr. Elmer Huerta wrote.
Hard numbers linking insurance status and cancer deaths are scarce, in part because death certificates don't say whether those who died were insured.
An Associated Press estimate - based on hospital cancer deaths in 2005 gathered by the US Agency for Healthcare Research and Quality information and other data - suggests that at least 20,000 of the nation's 560,000 annual cancer deaths are uninsured when they die. Experts said that estimate sounds reasonable.
That's around 4 percent of the total cancer death toll. One reason is that most fatal cancers occur in people 65 or older - an age group covered by the federal Medicare program. Another is that more than 80 percent of adults under 65 have some form of coverage, including private insurance or the Medicaid program for the poor, according to various estimates.
Some are enrolled in Medicaid or other programs after diagnosis, when the condition worsens and their finances erode. But such 11th hour coverage can be too late; early detection is the key to catching many cancers before they've grown beyond control, experts said.
"Insurance makes a big difference in how early you are detecting disease," said Ken Thorpe, an Emory University health policy researcher.
In the new study, researchers analyzed information from 1,500 US hospitals that provide cancer care. They focused on nearly 600,000 adults under age 65 who first appeared in the database in 1999 and 2000 and who had either no insurance, private insurance or Medicaid.