The “Medicare effect” on head and neck cancer diagnosis and survival

• Published in: Head & neck Vol. 45; no. 7; pp. 1663 - 1675
• Main Authors: Smith, Joshua B., Jayanth, Prerana, Hong, Scott A., Simpson, Matthew C., Massa, Sean T.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.07.2023; Wiley Subscription Services, Inc
• Subjects: access; Age; Cancer; Diagnosis; Epidemiology; equity; Head & neck cancer; head and neck cancer; Head and neck carcinoma; HPV; insurance; Medicaid; Medicare; Mortality; Patients; quality of life; Squamous cell carcinoma; insurance; access; Medicare; head and neck cancer; quality of life; equity; HPV
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.27379

Background Uninsured individuals age 55–64 experience disproportionately poor outcomes compared to their insured counterparts. Adequate coverage may prevent these delays. This study investigates a “Medicare‐effect” on head and neck squamous cell carcinoma (HNSCC) diagnosis and treatment. Methods The Surveillance, Epidemiology, and End Results (SEER) database was queried for persons ages 60–70 years in the United States from 2000 to 2016 with HNSCC. A “Medicare effect” was defined as an increase in incidence, reduction in advanced stage presentation, and/or decrease in cancer‐specific mortality (CSM). Results Compared to their Medicaid or uninsured counterparts, patients age 65 have an increased incidence of HNSCC diagnosis, reduction in advanced stage presentation, decrease in cancer‐specific mortality, and higher likelihood of receiving cancer‐specific surgery. Conclusions Patients age 65 with Medicare have decreased incidence of HNSCC, less hazard of late‐stage diagnosis, and lower cancer‐specific mortality than their Medicaid or uninsured counterparts, supporting the idea of a “Medicare effect” in HNSCC.