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Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Presentations: 1
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
40P - Comparison of clinical characteristics and survival of lung cancer patients in a Canadian province and in the United States according to insurance status (ID 609)
12:30 - 13:00 | Presenting Author(s): A. Matutino
Cancer outcomes in the United States (US) was shown to be influenced by insurance status for the most types of cancer. In Canada, health care access is similar for the whole population. The Affordable Care Act (ACA) was implemented to expand access to health care coverage in the US. This study aimed to compare clinical characteristics and survival of lung cancer pts in a Canadian province and in the US according to insurance status over the years.
Data was obtained from the US SEER database and the Alberta, Canada Glans-Look lung cancer database. Pts were included if they were 18-64yo and diagnosed between 2007–2012. To account for the introduction of the ACA in the US, data was also analyzed by years 2007–2009 vs 2010–2012. Overall survival (OS) was evaluated over 26 months and the 25th, 50th and 75th percentiles of survival time, if reached, were estimated. Pearson's χ was used to assess significance of associations with diagnosis year, and unadjusted associations were compared using the log-rank test. Hazard ratio's (HR) were estimated using the Cox proportional hazards model.
A total of 65,791 pts from the SEER database and 1,034 pts from the Canada Glans-Look database were included. The comparison of survival outcomes of the Canadian population vs the US population based on insurance status (insured, Medicaid, uninsured) showed that the Canadian survival was similar to the US Medicaid group (11.7 vs 10 m at percentile 50 of survival), while US insured group had a better outcome of 16 months (p < 0001). When comparing 2007–2009 vs 2010–2012, overall survival remained similar for the Canadian population (10.9 vs 13 m, p = 0.8876), while it improved in the post-ACA years for the US population (13 vs 14 m p = 0.0002). In both Canadian and US population, female sex, earlier stages and adenocarcinoma pts presented with better survival outcomes (p < 0.0001).
Among lung cancer pts, the Canadian outcomes resembled the US Medicaid group for survival outcomes. In the US population, Medicaid and uninsured pts experienced worse survival. Survival rates in all insurance groups improved after the implementation of the ACA in the US, remaining similar in the Canadian population.
Clinical trial identification:
Legal entity responsible for the study:
Alberta Health Services
Has not received any funding
All authors have declared no conflicts of interest.
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