Traditional Non-Medicaid Insurance Associated With Earlier Testicular Cancer Diagnosis Interview with:
Sarah C. Markt, ScD, MPH
Research Associate
Harvard T.H. Chan School of Public Health | Department of Epidemiology
Boston, MA 02115 What is the background for this study?

Response: Age is associated with insurance status, with the greatest proportion of uninsured between the ages of 20 to 34 years. For testicular cancer this is important because the median age of diagnosis is 33 years and the majority of the cases are diagnosed between then ages of 20 and 44 years. Previous studies have shown that people with cancer who are uninsured are more likely to present with worse disease, less likely to receive treatment, and are more likely to die of their disease, compared with those who have private insurance. Furthermore, the associations between Medicaid coverage and cancer outcomes have been conflicting. What are the main findings?

Response: We found that men without insurance and those with Medicaid insurance were more likely to be diagnosed with metastatic disease and were less likely to receive treatment, compared to those with private insurance. Finally, uninsured men had an 88% increased risk and men with Medicaid a 58% increased risk of testicular cancer death, compared with insured men. What should readers take away from your report?

Response: In conclusion, in this study we found that traditional health insurance—but not Medicaid insurance—was associated with earlier stage of disease at diagnosis, increased treatment, and better survival among men diagnosed with germ cell tumors in this large, population-based study. Our results suggest that increasing access to health care is required to decrease the deaths of young men with GCT, a disease that is curable even when metastatic. What recommendations do you have for future research as a result of this study?

Response: Further research into the role of insurance status and adverse outcomes will be necessary with the uptake of the ACA and expanded insurance coverage, particularly for those most at risk for germ cell tumors. Thank you for your contribution to the community.


Insurance status and disparities in disease presentation, treatment, and outcomes for men with germ cell tumors
Sarah C. Markt, Carlos A. Lago-Hernandez, Rowan E. Miller, Brandon A. Mahal, Brandon Bernard, Laurence Albiges, Lindsay A. Frazier, Clair J. Beard, Alexi A. Wright and Christopher J. Sweeney
Journal CANCER 8 AUG 2016 | DOI: 10.1002/cncr.30159

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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