Effects of Health Insurance on Tumor Stage, Treatment, and Survival in Large Cohorts of Patients with Breast and Colorectal Cancer

To examine the impact of health insurance status on tumor stage at diagnosis, treatment rendered, and overall survival, we identified 52,566 breast cancer patients and 34,316 colorectal cancer patients aged 20 or older in 2007–2010 from Texas Cancer Registry. Those aged younger than 65 years without health insurance coverage had significantly higher risks of mortality than those with private health insurance regardless of tumor stage, chemotherapy, or surgery for colorectal cancer. However, in patients younger than 65 years with breast cancer, the risk of mortality was not significantly higher for those who received chemotherapy or cancer-directed surgery in patients without insurance coverage compared with those with private health insurance. In Medicare beneficiaries aged 65 years or older, risk of mortality was not significantly different between those with Medicare only and those with additional private health insurance, except an increased mortality in patients without chemotherapy for breast and colorectal cancer and in those without receiving surgery for colorectal cancer.