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February 18, 2008 WASHINGTON (Reuters) - Uninsured Americans and those in a government health program for the poor are far more likely to have advanced diseases when diagnosed with cancer than those with private coverage, researchers said on Sunday. A major factor seems to be that many of these people are not getting routine screenings for various types of cancer that could detect the disease in its early stages when it is most treatable and least deadly, according to the researchers. Led by Dr. Michael Halpern of the American Cancer Society, the team examined data on 3.7 million Americans diagnosed with 12 common types of cancer between 1998 and 2004. The uninsured were 2.1 times as likely and those covered by Medicaid 80 percent more likely to have advanced-stage cancer at the time of their first cancer diagnoses compared with those with private health insurance. The study published in the medical journal Lancet Oncology also showed blacks and to a lesser extent Hispanics, regardless of insurance status, were more likely than whites to have advanced cancer when first diagnosed. The government estimates there are 47 million people without health insurance in a country of about 300 million people. Health care is a prominent issue in the U.S. presidential campaign. "We consistently found across a wide variety of cancers that uninsured individuals and those covered by Medicaid were more likely to be diagnosed with advanced disease," Halpern said in a telephone interview. "And this was especially true for the cancers that could be diagnosed early by screening, like colorectal cancer, or have symptoms early in disease like bladder cancer," Halpern added. The increased risk for later-stage diagnosis also was seen in diseases such as breast and lung cancer as well as the skin cancer melanoma. Many cancers respond well to treatment when caught in their earliest stages, before cancer cells have spread from one part of the body to other parts. More advanced cancer is much harder to treat and much more likely to kill. The nationwide findings confirmed similar results of more limited studies looking at particular regions of the country dating from the 1990s. The data used in the new study came from a database containing information on about three-quarters of people diagnosed with cancer in the United States. Medicaid is a state-federal program that helps pay for health care for low-income people, the disabled and some others. Individual states determine who is eligible and what services are covered. Regarding racial and ethnic disparities, Halpern said explanations may include problems in patient-doctor communication and health literacy, as well as less trust of the medical care system among blacks and Hispanics. Copyright 2008 Reuters. Click for Restrictions.
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