Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Dec;60(13):3225-3234.
doi: 10.1080/10428194.2019.1623884. Epub 2019 Jul 5.

Insurance status impacts overall survival in Burkitt lymphoma

Jordan S Goldstein  1 , Jeffrey M Switchenko  2 , Madhusmita Behera  2 , Christopher R Flowers  3 , Jean L Koff  3
Affiliations
Comparative Study

Insurance status impacts overall survival in Burkitt lymphoma

Jordan S Goldstein et al. Leuk Lymphoma. 2019 Dec.

Abstract

The impact of insurance status on clinical outcomes in Burkitt (BL) and plasmablastic (PBL) lymphomas remains unknown. We used the National Cancer Database to examine insurance status' effect on overall survival (OS) in adults diagnosed with these lymphomas between 2004 and 2014. BL patients with private insurance had significantly better OS compared to those without. In patients aged <65 years, hazard ratios were 1.4 for uninsured status (95% confidence interval 1.2-1.7), 1.2 for Medicaid (95% CI 1.0-1.4), and 1.5 for Medicare (95% CI 1.2-1.9). For patients aged >65 years, hazard ratio for uninsured status was 8.4 (95% CI 2.5-28.3). Conversely, underinsured PBL patients experienced no difference in OS. Thus, expanding insurance-related access to care may improve survival in BL, for which curative therapy exists, but not PBL, where more effective therapies are needed. Our findings add to mounting evidence that adequate health insurance is particularly important for patients with curable cancers.

Keywords: Burkitt lymphoma; insurance; non-Hodgkin lymphoma; plasmablastic lymphoma; survival.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. CONSORT diagram
depicting Burkitt lymphoma case selection process. A similar process was also executed for cases of plasmablastic lymphoma.
Figure 2.
Figure 2.. Overall survival by insurance status for patients with Burkitt lymphoma (BL) or plasmablastic lymphoma (PBL) in the NCDB, 2004–2014.
(A) BL patients aged < 65. (B) BL patients aged ≥ 65. (C) PBL patients aged <65. (D) PBL patients aged ≥ 65. P-values obtained by log-rank test.
See this image and copyright information in PMC

References

    1. Halpern MT, Ward EM, Pavluck AL, Schrag NM, Bian J, Chen AY. Association of insurance status and ethnicity with cancer stage at diagnosis for 12 cancer sites: a retrospective analysis. Lancet Oncol 2008;9:222–231. - PubMed
    1. Ward E, Halpern M, Schrag N, et al. Association of insurance with cancer care utilization and outcomes. CA Cancer J Clin 2008;58:9–31. - PubMed
    1. Ward EM, Fedewa SA, Cokkinides V, Virgo K. The association of insurance and stage at diagnosis among patients aged 55 to 74 years in the national cancer database. Cancer J 2010;16:614–621. - PubMed
    1. Martin S, Ulrich C, Munsell M, Taylor S, Lange G, Bleyer A. Delays in cancer diagnosis in underinsured young adults and older adolescents. Oncologist 2007;12:816–824. - PubMed
    1. Teras LR, DeSantis CE, Cerhan JR, Morton LM, Jemal A, Flowers CR. 2016 US lymphoid malignancy statistics by World Health Organization subtypes. CA Cancer J Clin 2016. - PubMed

Publication types

MeSH terms

LinkOut - more resources