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Survival among lung cancer patients: comparison of the U.S. military health system and the surveillance, epidemiology, and end results (SEER) program by health insurance status.
Lin, Jie; Shriver, Craig D; Zhu, Kangmin.
Afiliação
  • Lin J; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, 6720A Rockledge Drive, Suite 310, Bethesda, MD, 20817, USA. jie.lin.ctr@usuhs.edu.
  • Shriver CD; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, 20817, USA. jie.lin.ctr@usuhs.edu.
  • Zhu K; Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA. jie.lin.ctr@usuhs.edu.
Cancer Causes Control ; 35(1): 21-31, 2024 Jan.
Article em En | MEDLINE | ID: mdl-37532916
PURPOSE: The U.S. military health system (MHS) provides beneficiaries with universal health care while health care access varies in the U.S. general population by insurance status/type. We divided the patients from the U.S. general population by insurance status/type and compared them to the MHS patients in survival. METHODS: The MHS patients were identified from the Department of Defense's Automated Central Tumor Registry (ACTUR). Patients from the U.S. general population were identified from the Surveillance, Epidemiology, and End Results (SEER) program. Multivariable Cox regression analysis was conducted to compare different insurance status/type in SEER to ACTUR in overall survival. RESULTS: Compared to ACTUR patients with non-small cell lung cancer (NSCLC), SEER patients showed significant worse survival. The adjusted hazard ratios (HRs) were 1.08 [95% Confidence Interval (CI) = 1.03-1.13], 1.22 (95% CI = 1.16-1.28), 1.40 (95% CI = 1.33-1.47), 1.50 (95% CI = 1.41-1.59), for insured, insured/no specifics, Medicaid, and uninsured patients, respectively. The pattern was consistently observed in subgroup analysis by race, gender, age, or tumor stage. Results were similar for small cell lung cancer (SCLC), although they were only borderline significant in some subgroups. CONCLUSION: The survival advantage of patients receiving care from a universal health care system over the patients from the general population was not restricted to uninsured or Medicaid as expected, but was present cross all insurance types, including patients with private insurance. Our findings highlight the survival benefits of universal health care system to lung cancer patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Serviços de Saúde Militar / Neoplasias Pulmonares Tipo de estudo: Prognostic_studies / Screening_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: Cancer Causes Control Assunto da revista: EPIDEMIOLOGIA / NEOPLASIAS Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Serviços de Saúde Militar / Neoplasias Pulmonares Tipo de estudo: Prognostic_studies / Screening_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: Cancer Causes Control Assunto da revista: EPIDEMIOLOGIA / NEOPLASIAS Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos