Monday, February 18, 2008
Without insurance cancer often found later
By Yvonne S. Lee
CNN Medical Producer

The late stages of cancer are brutal. I remember an ugly tangle of tubes around my grandmother's body, her desperate, humiliating struggle for each breath, her body slumped over as sweaty white skin hung off the emaciated body of this once-mighty woman.

She was the family matriarch, a woman who had fed three hungry children and a half-dozen nieces and nephews through the worst days of the Korean War. She started smoking because she was hungry. She got her first cigarettes from American soldiers stationed in Korea during the war. She said they helped her feel less ravenous.

Doctors weren't able to save her. Advanced lung cancer was hard to detect and just wasn't curable in the late 1970s. It still isn't. Only 16 percent of cases in the United States are detected in Stage 1, when tumors are still confined to the lung.

It turns out that thousands of patients in the U.S. have to endure what my grandmother did - trying to survive after their cancer is diagnosed at a late stage. But many of those people find out they have advanced cancer because they do not have health insurance - something my grandmother did have - and therefore have limited access to health care and early cancer screening.

A new American Cancer Society study published in the journal Lancet looked at 3.7 million cancer patients - the largest study of its kind - and found that uninsured and underinsured patients are twice as likely to learn about their cancer in its late stages of cancer as people who have private insurance.

When I read this, I thought about all the people who have to watch their loved ones die of cancers that could have been successfully treated had the disease been caught earlier. It seems tragic that if they'd had insurance, perhaps they would have gotten pre-screened for breast, colon and other cancers. Catching these cancers early means you're much more likely to live longer.

If colon cancer is diagnosed in Stage 1, you have a 93 percent chance of surviving five years. This drops to 8 percent if it's found at Stage 4. According to the study, uninsured people were twice as likely get their diagnosis at an advanced stage of colon cancer versus an early stage.

The statistics weren't any better for breast cancer. Women without insurance were nearly three times as likely to learn they have cancer at a later stage rather than an earlier stage. If breast cancer is diagnosed late, your chance of surviving five years goes down by 80 percent.

These are scary numbers when you consider that 47 million Americans don't have health insurance. That's 47 million people who are taking a chance, whether by circumstance or because they have no choice, that they won't become seriously ill; 47 million who may have to rely on emergency rooms if they do; 47 million who don't have the luxury of calling their family doctor to ask about a pain in their chest, or a lump in their breast. They just have to grin and bear it, or hope that it's nothing.

I think about having five more years with my grandmother. I would have asked her what it was like to live during the Japanese colonization of Korea, when she escaped with her family to China, or how she was able to feed her children during the Korean War, with only a sack of rice to get through most weeks.

For me, health insurance is not a political issue, it's a moral issue. Poverty shouldn't mean that you are more likely to die from diseases that we can treat effectively if caught early. It shouldn't mean you get less time with your kids, or grandkids - not in the richest country in the world.

Are you uninsured or on Medicaid? Was your cancer diagnosed at a later stage because you didn't have insurance? Tell us your story.

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Posted By Ann Curley, Assignment Manager, Medical News: 2:00 PM ET