Insurance Status Is Related to Receipt of Therapy and Survival in Patients with Early-Stage Pancreatic Exocrine Carcinoma

Objectives. The study objective was to determine how insurance status relates to treatment receipt and overall survival for patients with early-stage pancreatic exocrine carcinoma. Methods. SEER data were evaluated for 17,234 patients diagnosed with Stage I/II pancreatic exocrine carcinoma. Multivariate regression models controlled for personal characteristics to determine whether insurance status was independently associated with overall survival and receipt of radiation/surgery. Results. Odds of receiving radiation were 1.50 and 1.75 times higher for insured patients compared to Medicaid and uninsured patients, respectively (). Insured patients had 1.68 and 1.57 times increased odds of receiving surgery compared to Medicaid and uninsured patients (). Risk of death was 1.33 times greater () in Medicaid patients compared to insured patients; when further adjusted for treatment, the risk of death was attenuated but remained significant (HR = 1.16, ). Risk of death was 1.16 times higher for uninsured patients compared to insured patients (); when further adjusted for treatment, the risk of death was no longer significant (HR = 1.01, ). Conclusions. Uninsured and Medicaid-insured patients experience lower treatment rates compared to patients who have other insurances. The increased likelihood of treatment appears to explain the insured group’s survival advantage.

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