The role of health insurance coverage in cancer screening utilization

J Health Care Poor Underserved. 2008 Aug;19(3):842-56. doi: 10.1353/hpu.0.0048.

Abstract

Introduction: Although previous studies have shown a correlation between health insurance coverage and cancer screening, underinsurance and cancer screening among racial/ethnic minorities has not been examined.

Methods: Data from the 2000 and 2003 National Health Interview Surveys are used in this analysis. Cross-tabulations, age, and racial/ethnic group stratified regression analyses are used to examine associations between health insurance status and receipt of mammography, Pap testing, prostate specific antigen tests, fecal occult blood test (FOBT) and colorectal endoscopy.

Results: In overall models, uninsurance was associated with lower receipt of all tests except FOBT among participants ages 65-85 years. Underinsurance was associated with lower receipt of mammography among women under 65 years only.

Conclusion: These findings show age variation in the association between cancer screening and health insurance coverage. In addition, health insurance appears to act similarly across racial/ethnic groups. Further examination of underinsurance in cancer screening utilization and other health behaviors is needed.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / prevention & control
  • Colonoscopy / economics
  • Colonoscopy / statistics & numerical data
  • Colorectal Neoplasms / prevention & control
  • Female
  • Health Care Surveys
  • Humans
  • Insurance Coverage*
  • Male
  • Mammography / economics
  • Mammography / statistics & numerical data
  • Mass Screening / economics*
  • Mass Screening / statistics & numerical data*
  • Medically Uninsured / ethnology*
  • Medically Uninsured / statistics & numerical data
  • Middle Aged
  • Neoplasms / classification
  • Neoplasms / ethnology
  • Neoplasms / prevention & control*
  • Occult Blood
  • Prostate-Specific Antigen / analysis
  • Prostatic Neoplasms / prevention & control
  • Sex Factors
  • Uterine Cervical Neoplasms / prevention & control
  • Vaginal Smears / economics
  • Vaginal Smears / statistics & numerical data

Substances

  • Prostate-Specific Antigen