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Study Finds Lack of Health Insurance May Hinder Recommended Cancer Screening in Unemployed Adults


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In a recent study published by Stacey Fedewa, PhD, and colleagues in the journal Cancer, unemployed individuals were less likely to have health insurance and be up to date on getting recommended cancer screening tests. Analyses revealed that their lack of health insurance coverage accounted for their lower screening rates.

During the COVID-19 pandemic, unemployment rates in the United States rose considerably. To examine associations between unemployment, health insurance, and cancer screening, researchers analyzed information from adults younger than age 65 who responded to the 2000–2018 National Health Interview Survey, a nationally representative annual survey of the general population.

Stacey Fedewa, PhD

Stacey Fedewa, PhD

Unemployed adults were four times more likely to lack insurance than employed adults (41.4% vs 10.0%). A lower proportion of unemployed adults had received up-to-date cervical (78.5% vs 86.2%), breast (67.8% vs 77.5%), colorectal (41.9% vs 48.5%), and prostate (25.4% vs 36.4%) cancer screening. These differences were eliminated after accounting for health insurance coverage.

“People who were unemployed at the time of the survey were less likely to have a recent cancer screening test, and they were also less likely to be up-to-date with their cancer screenings over the long term. This suggests that being unemployed at a single point in time may hinder both recent and potentially longer-term screening practices,” said Dr. Fedewa. This can increase a person’s risk of being diagnosed with late-stage disease.

“Our finding that insurance coverage fully accounted for unemployed adults’ lower cancer screening utilization is potentially good news, because it’s modifiable,” Dr. Fedewa added. “When people are unemployed and have health insurance, they have screening rates that are similar to employed adults.”

The findings point to the importance of insurance coverage for enabling individuals to receive recommended cancer screening tests and indicate that greater efforts are needed to offer insurance to all people, regardless of their employment status.

Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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