Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Cancer Causes & Control
Published in: Cancer Causes & Control 8/2017

01-08-2017 | Original paper

Sociodemographic disparities in survival for adolescents and young adults with cancer differ by health insurance status

Authors: Mindy C. DeRouen, Helen M. Parsons, Erin E. Kent, Brad H. Pollock, Theresa H. M. Keegan

Published in: Cancer Causes & Control | Issue 8/2017

Login to get access

Abstract

Purpose

To investigate associations of sociodemographic factors—race/ethnicity, neighborhood socioeconomic status (SES), and health insurance—with survival for adolescents and young adults (AYAs) with invasive cancer.

Methods

Data on 80,855 AYAs with invasive cancer diagnosed in California 2001–2011 were obtained from the California Cancer Registry. We used multivariable Cox proportional hazards regression to estimate overall survival.

Results

Associations of public or no insurance with greater risk of death were observed for 11 of 12 AYA cancers examined. Compared to Whites, Blacks experienced greater risk of death, regardless of age or insurance, while greater risk of death among Hispanics and Asians was more apparent for younger AYAs and for those with private/military insurance. More pronounced neighborhood SES disparities in survival were observed among AYAs with private/military insurance, especially among younger AYAs.

Conclusions

Lacking or having public insurance was consistently associated with shorter survival, while disparities according to race/ethnicity and neighborhood SES were greater among AYAs with private/military insurance. While health insurance coverage associates with survival, remaining racial/ethnic and socioeconomic disparities among AYAs with cancer suggest additional social factors also need consideration in intervention and policy development.
Literature
1.
Bleyer A, Budd T, Montello M (2006) Adolescents and young adults with cancer: the scope of the problem and criticality of clinical trials. Cancer 107:1645–1655CrossRefPubMed
2.
Bleyer A, Choi M, Fuller CD, Thomas CR Jr, Wang SJ (2009) Relative lack of conditional survival improvement in young adults with cancer. Semin Oncol 36:460–467CrossRefPubMed
3.
Keegan THRL, Barr RD, Geiger AM, Dahlke DV, Pollock BH, Bleyer WA (2016) National cancer institute next steps for adolescent and young adult ONCOLOGY epidemiology working group. Comparison of cancer survival trends in the United States of adolescents and young adults with those in children and older adults. Cancer 122(7):1009–1016CrossRefPubMed
4.
Bleyer A, Ulrich C, Martin S (2012) Young adults, cancer, health insurance, socioeconomic status, and the Patient Protection and Affordable Care Act. Cancer 118:6018–6021CrossRefPubMed
5.
Keegan TH, Tao L, DeRouen MC et al (2014) Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers? J Cancer Surviv 8:282–292CrossRefPubMedPubMedCentral
6.
Parsons HM, Schmidt S, Harlan LC et al (2014) Young and uninsured: insurance patterns of recently diagnosed adolescent and young adult cancer survivors in the AYA HOPE study. Cancer 120:2352–2360CrossRefPubMedPubMedCentral
7.
Derouen MC, Gomez SL, Press DJ, Tao L, Kurian AW, Keegan TH (2013) A population-based observational study of first-course treatment and survival for adolescent and young adult females with breast cancer. J Adolesc Young Adult Oncol 2:95–103CrossRefPubMedPubMedCentral
8.
Keegan TH, Grogan RH, Parsons HM et al (2015) Sociodemographic disparities in differentiated thyroid cancer survival among adolescents and young adults in California. Thyroid 25:635–648CrossRefPubMedPubMedCentral
9.
Keegan TH, Press DJ, Tao L et al (2013) Impact of breast cancer subtypes on 3-year survival among adolescent and young adult women. Breast Cancer Res 15:R95CrossRefPubMedPubMedCentral
10.
Kent EE, Morris RA, Largent JA, Ziogas A, Sender LS, Anton-Culver H (2010) Socioeconomic impacts on survival differ by race/ethnicity among adolescents and young adults with non-Hodgkin’s lymphoma. J Cancer Epidemiol 2010:824691PubMedPubMedCentral
11.
12.
Robbins AS, Lerro CC, Barr RD (2014) Insurance status and distant-stage disease at diagnosis among adolescent and young adult patients with cancer aged 15 to 39 years: National Cancer Data Base, 2004 through 2010. Cancer 120:1212–1219CrossRefPubMed
13.
Rosenberg AR, Kroon L, Chen L, Li CI, Jones B (2015) Insurance status and risk of cancer mortality among adolescents and young adults. Cancer 121:1279–1286CrossRefPubMed
14.
Keegan TH, DeRouen MC, Parsons HM et al (2016) Impact of treatment and insurance on socioeconomic disparities in survival after adolescent and young adult Hodgkin lymphoma: a population-based study. Cancer Epidemiol Biomark Prev 25:264–273CrossRef
15.
Bleyer A, Barr R, Hayes-Lattin B, Thomas D, Ellis C, Anderson B (2008) The distinctive biology of cancer in adolescents and young adults. Nat Rev Cancer 8:288–298CrossRefPubMed
16.
Section CS. (1997) Cancer Reporting in California: Standards for Automated Reporting. California Cancer Reporting System Standards, Volume II. Sacramento, California, USA: Cancer Surveillance Section, California Department of Health Services
17.
Section CS. (1997) Abstract and Coding Procedures for Hospitals. California Cancer Reporting System Standards, Volume I. Sacramento, California, USA: Cancer Surveillance Section, California Department of Health Services
18.
Section CS. (1997) Reporting Procedures for Physicians. California Cancer Reporting System Standards, Volume IV. Sacramento, California, USA: Cancer Surveillance Section, California Department of Health Services
19.
Sections CS. (1997) Cancer Reporting in California: Data Standard for Regional Registries and California Cancer Registry. California Cancer Reporting System Stadards, Volume III. Sacramento, California, USA: Cancer Surveillance Section, California Department of Health Services
20.
Barr RD, Holowaty EJ, Birch JM (2006) Classification schemes for tumors diagnosed in adolescents and young adults. Cancer 106:1425–1430CrossRefPubMed
21.
Gomez SL, Glaser SL (2006) Misclassification of race/ethnicity in a population-based cancer registry (United States). Cancer Causes Control 17:771–781CrossRefPubMed
22.
Yost K, Perkins C, Cohen R, Morris C, Wright W (2001) Socioeconomic status and breast cancer incidence in California for different race/ethnic groups. Cancer Causes Control 12:703–711CrossRefPubMed
23.
Yang JSC, Harrati A, Clarke C, Keegan THM, Gomez SL (2014) Developing an area-based socioeconomic measure from American Community Survey data. Cancer Prevention Institute of California, Fremont
24.
Smith EC, Ziogas A, Anton-Culver H (2013) Delay in surgical treatment and survival after breast cancer diagnosis in young women by race/ethnicity. JAMA Surg 148:516–523CrossRefPubMed
25.
Martin S, Ulrich C, Munsell M, Taylor S, Lange G, Bleyer A (2007) Delays in cancer diagnosis in underinsured young adults and older adolescents. Oncologist 12:816–824CrossRefPubMed
26.
Kleinbaum DG, Klein M (2005) Chapter 5: the stratified cox procedure survival analysis: a self-learning text, Second Edition edn. Springer, New York, pp 173–210
27.
Butow P, Palmer S, Pai A, Goodenough B, Luckett T, King M (2010) Review of adherence-related issues in adolescents and young adults with cancer. J Clin Oncol 28:4800–4809CrossRefPubMed
28.
29.
DeRouen MC, Smith AW, Tao L et al (2015) Cancer-related information needs and cancer’s impact on control over life influence health-related quality of life among adolescents and young adults with cancer. Psychooncology 24:1104–1115CrossRefPubMedPubMedCentral
30.
Howlader N, Noone A, Kraphco M et al (2012) SEER cancer statistics review, 1975-2009 (vintage 2009 populations). National Cancer Institute, Bethesda
31.
Charles S (2015) Adult medi-cal enrollment surges, uninsured rate plummets in 2014. UCLA Center for Health Policy Research, Los Angeles
32.
Ward E, Halpern M, Schrag N et al (2008) Association of insurance with cancer care utilization and outcomes. Cancer J Clin 58:9–31CrossRef
33.
Lillie-Blanton M, Hoffman C (2005) The role of health insurance coverage in reducing racial/ethnic disparities in health care. Health Aff (Millwood) 24:398–408CrossRef
34.
Gorey KM, Luginaah IN, Holowaty EJ, Zou G, Hamm C, Balagurusamy MK (2013) Mediation of the effects of living in extremely poor neighborhoods by health insurance: breast cancer care and survival in California, 1996 to 2011. Int J Equity Health 12:6CrossRefPubMedPubMedCentral
35.
Banegas MP, Guy GP Jr, de Moor JS et al (2016) For working-age cancer survivors, medical debt and bankruptcy create financial hardships. Health Aff (Millwood) 35:54–61CrossRef
36.
37.
38.
Shankaran V, Jolly S, Blough D, Ramsey SD (2012) Risk factors for financial hardship in patients receiving adjuvant chemotherapy for colon cancer: a population-based exploratory analysis. J Clin Oncol 30:1608–1614CrossRefPubMed
39.
Ubel PA, Abernethy AP, Zafar SY (2013) Full disclosure–out-of-pocket costs as side effects. N Engl J Med 369:1484–1486CrossRefPubMed
40.
Yabroff KR, Dowling EC, Guy GP et al (2015) Financial hardship associated with cancer in the United States: findings from a population-based sample of adult cancer survivors. J Clin Oncol 34(3):259–267CrossRefPubMedPubMedCentral
41.
Zafar SY, Abernethy AP (2013) Financial toxicity, part I: a new name for a growing problem. Oncology (Williston Park) 27(80–1):149
42.
Zafar SY, Peppercorn JM, Schrag D et al (2013) The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient’s experience. Oncologist 18:381–390CrossRefPubMedPubMedCentral
43.
Neugut AI, Subar M, Wilde ET et al (2011) Association between prescription co-payment amount and compliance with adjuvant hormonal therapy in women with early-stage breast cancer. J Clin Oncol 29:2534–2542CrossRefPubMedPubMedCentral
44.
Freedman RA, Virgo KS, He Y et al (2011) The association of race/ethnicity, insurance status, and socioeconomic factors with breast cancer care. Cancer 117:180–189CrossRefPubMed
45.
Wu XC, Lund MJ, Kimmick GG et al (2012) Influence of race, insurance, socioeconomic status, and hospital type on receipt of guideline-concordant adjuvant systemic therapy for locoregional breast cancers. J Clin Oncol 30:142–150CrossRefPubMed
46.
American Society of Clinical O (2016) The State of Cancer Care in America, 2016: a report by the american society of clinical oncology. J Oncol Pract 12:339–383CrossRef
47.
Keegan TH, Lichtensztajn DY, Kato I et al (2012) Unmet adolescent and young adult cancer survivors information and service needs: a population-based cancer registry study. J Cancer Surviv 6:239–250CrossRefPubMedPubMedCentral
48.
Keegan TH, DeRouen MC, Press DJ, Kurian AW, Clarke CA (2012) Occurrence of breast cancer subtypes in adolescent and young adult women. Breast Cancer Res 14:R55CrossRefPubMedPubMedCentral
49.
Jacobs EA, Rathouz PJ, Karavolos K et al (2014) Perceived discrimination is associated with reduced breast and cervical cancer screening: the Study of Women’s Health Across the Nation (SWAN). J Womens Health (Larchmt). 23:138–145CrossRefPubMedCentral
50.
Benjamins MR, Whitman S (2014) Relationships between discrimination in health care and health care outcomes among four race/ethnic groups. J Behav Med 37:402–413CrossRefPubMed
51.
Parker LJ, Hunte H, Ohmit A (2015) Discrimination in health care: correlates of health care discrimination among black males. Am J Mens Health
52.
Krieger N (1999) Embodying inequality: a review of concepts, measures, and methods for studying health consequences of discrimination. Int J Health Serv 29:295–352CrossRefPubMed
53.
Krieger N, Davey Smith G (2004) Bodies count, and body counts: social epidemiology and embodying inequality. Epidemiol Rev 26:92–103CrossRefPubMed
54.
55.
Tehranifar P, Neugut AI, Phelan JC et al (2009) Medical advances and racial/ethnic disparities in cancer survival. Cancer Epidemiol Biomark Prev 18:2701–2708
56.
Gomez SL, Shariff-Marco S, DeRouen M et al (2015) The impact of neighborhood social and built environment factors across the cancer continuum: current research, methodological considerations, and future directions. Cancer 121:2314–2330CrossRefPubMedPubMedCentral
57.
Clegg LX, Reichman ME, Hankey BF et al (2007) Quality of race, Hispanic ethnicity, and immigrant status in population-based cancer registry data: implications for health disparity studies. Cancer Causes Control 18:177–187CrossRefPubMed
Metadata
Title
Sociodemographic disparities in survival for adolescents and young adults with cancer differ by health insurance status
Authors
Mindy C. DeRouen
Helen M. Parsons
Erin E. Kent
Brad H. Pollock
Theresa H. M. Keegan
Publication date
01-08-2017
Publisher
Springer International Publishing
Published in
Cancer Causes & Control / Issue 8/2017
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-017-0914-y

Other articles of this Issue 8/2017

Cancer Causes & Control 8/2017 Go to the issue

Original paper

Coffee consumption and risk of non-Hodgkin’s lymphoma: evidence from the Italian multicentre case–control study

Letter to the editor

Response to: systematic review of dietary, nutritional, and physical activity interventions for the prevention of prostate cancer progression and mortality by Hackshaw-McGeagh and Colleagues

Original paper

Trichomonas vaginalis infection and risk of prostate cancer: associations by disease aggressiveness and race/ethnicity in the PLCO Trial

Original paper

Racial differences in the effects of comorbidity on breast cancer-specific survival

Original paper

Tooth loss and liver cancer incidence in a Finnish cohort

Original paper

Coffee consumption and risk of renal cell carcinoma
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits