A new study by researchers at the American Cancer Society (ACS) shows that adults in the United States with prior insurance coverage disruptions are significantly less likely to receive guideline-concordant and past-year cancer screening, compared to people with continuous coverage.
The guideline-concordant screening rates were 63.1% vs. 80.5% for breast cancer, 47.1% vs. 65.4% for colorectal cancer, and 73.1% vs. 80.0% for cervical cancer among people with private health insurance coverage. People without health insurance coverage had the lowest screening levels. The findings were presented at the annual American Society of Clinical Oncology (ASCO) Quality Care Symposium in Boston, October 27 – 28, 2023.
In the study, researchers, led by Kewei Sylvia Shi, associate scientist in health services research at the American Cancer Society, identified adults in the U.S. eligible for breast, colorectal, and/or cervical cancer screening from the 2010, 2015, 2018, 2019, and 2021 National Health Interview Surveys. Adults were categorized into five groups based on insurance type at the time of the survey and prior coverage disruptions (defined as any lack of insurance during the prior 12 months). Researchers looked at whether those eligible had screening ever, within the past year, and if the screening was concordant with the U.S. Preventive Services Task Force guidelines available at the time of each survey.
The research also showed that people with continuous private or public insurance coverage had higher rates of past-year screenings across all three cancer types studied, compared with their counterparts with prior coverage disruptions. Among those eligible for breast cancer screening, for example, past-year screening for individuals with private coverage with and without prior disruptions were 62.2% and 44.1%, respectively. Similarly, among people with public coverage, 51.4% with continuous coverage received breast cancer screening in the previous year, while 36.9% with prior coverage disruptions did.