Insurance Status and Survival of Patients with Salivary Gland Cancer

Anirudh Saraswathula, Uchechukwu C. Megwalu

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Objectives: To evaluate the impact of insurance status on survival among patients with major salivary gland cancer. Study Design: Retrospective cohort study. Setting: SEER program. Subjects and Methods: We included patients aged <65 years diagnosed with major salivary gland cancers from 2007 to 2013. Those aged ≥65 years were excluded due to issues ascertaining insurance status. The independent variable was insurance status (insured, uninsured, or Medicaid); the primary outcome measure was overall survival (OS); and the secondary outcome measure was disease-specific survival (DSS). Results: Compared with insured patients, uninsured and Medicaid patients were more likely to present with stage III-IV disease (uninsured: odds ratio [OR], 1.57; 95% CI, 1.09-2.27; Medicaid_ OR, 1.67; 95% CI, 1.27-2.20) and with distant metastasis (uninsured: OR, 2.10; 95% CI, 1.18-3.57; Medicaid_ OR, 1.96; 95% CI, 1.25-3.01) after adjusting for demographic and tumor variables. Uninsured and Medicaid patients also had worse OS (uninsured: hazard ratio [HR], 1.62; 95% CI, 1.14-2.29; Medicaid_ HR, 1.74; 95% CI, 1.33-2.38) and DSS (uninsured: HR, 1.57; 95% CI, 1.08-2.29; Medicaid_ HR, 1.68; 95% CI, 1.25-2.25) after adjusting for demographic and tumor variables. After further adjusting for treatment variables, only Medicaid status was significantly associated with worse OS (HR, 1.71; 95% CI, 1.30-2.26) and DSS (HR, 1.65; 95% CI, 1.23-2.23). Conclusions: Insurance status is associated with stage at presentation and survival among patients with salivary gland cancer.

Original languageEnglish
Pages (from-to)998-1005
Number of pages8
JournalOtolaryngology - Head and Neck Surgery
Volume159
Issue number6
DOIs
StatePublished - 1 Dec 2018
Externally publishedYes

Keywords

  • SEER program
  • health disparities
  • insurance
  • salivary gland cancer

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