Insurance coverage a primary factor of breast cancer mortality

A recent study conducted at an academic safety net hospital may have identified critical predictors of breast cancer mortality risk. The results were published in Academic Radiology. [1]

The research, spanning from 2008 to 2014 and involving 907 patients, aimed to identify factors associated with lower mortality rates and uncover disparities in screening practices. The study's findings pointed to two significant predictors of higher mortality rates among women treated for breast cancer at the safety net hospital: increasing age and a more advanced stage at diagnosis. 

One of the study's standout findings was the association between shorter screening times and lower all-cause mortality. Patients with more advanced stage cancers at the time of diagnosis tended to have longer screening times, indicating potential delays in certain patients receiving an accurate diagnosis. Despite disparities in screening practices, the study revealed that the safety net infrastructure at the institution effectively provided equitable cancer care once a diagnosis was confirmed.

Notably, there were no significant differences in mortality based on race or ethnicity, highlighting a level playing field in terms of outcomes once cancer was confirmed.

The under-insured suffer most 

A major determining factor in mortality rates was disparities in insurance coverage and the role that played in screening speed and accuracy. Patients covered by Medicaid, unspecified insurance, or lacking insurance, were less likely to undergo screening before diagnosis compared to their privately insured counterparts.

“The interplay of insurance status to timely access to care, whether for preventative screening or prompt breast cancer treatment, presents another opportunity to improve outcomes from a breast cancer diagnosis,” wrote the authors led by Alexander Boyko, MD, of Boston Medical Center. “Although the Affordable Care Act should make it possible for all women, regardless of socioeconomic status, to have access to annual screening mammography, a recent 2023 study revealed that up to 20% of women perceive a co-pay or deductible associated with the downstream costs of diagnostic imaging and diagnosis as a major deterrent to screening. Another recently published cross-sectional study linked patient-reported cost concerns to lower mammographic utilization.”

Boyko and co-authors emphasized the study findings underscore the continued importance of early breast cancer screening. The identified predictors, such as increasing age and advanced stage at diagnosis, signal a need for targeted interventions to address disparities in screening practices, particularly among underserved populations—especially those who can’t afford care. 


Chad Van Alstin Health Imaging Health Exec

Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.

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