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Why We Need Universal Healthcare

Uninsured women are three times more likely than the well-insured to have their breast cancers diagnosed when it may be too late to cure them, according to a major study published this week by the American Cancer Society. Uninsured patients with colon cancer are twice as likely to be diagnosed in the late stages, it found. Previous, smaller studies have shown similar results, but this piece of research included 3.7 million patients — about 75 percent of all U.S. cancer patients diagnosed between 1998 and 2004.

Both colorectal and breast cancers can be detected with routine screening, which is precisely what the uninsured don’t get. Interestingly, the rate of late-stage diagnosis of ovarian and pancreatic cancers–two diseases that are difficult to detect early–was roughly the same in insured and uninsured patients.

The authors found that Medicaid does a bad job of getting people to doctors before their cancers have progressed; Medicaid patients were nearly as likely as the uninsured to be in Stage III or Stage IV of breast or colon cancer when diagnosis occurred. Hispanics and, especially, blacks, also are more likely to have their cancers diagnosed late, regardless of health insurance status. This points to “social and cultural factors which might limit access” for the poor, the authors write–things as simple as lack of transport and proximity to doctors, or as complex as lack of education, fear, stoicism and denial.

The study appeared in the Feb. 15 issue of Lancet Oncology; the abstract is linked here.

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