Association of insurance status with survival in patients with cutaneous T-cell lymphoma

Abstract

The effect of insurance status on overall survival (OS) of patients with cutaneous T-cell lymphoma (CTCL) is unclear. We identified 11,861 patients from the US National Cancer Data Base diagnosed with CTCL from 2004–2014, of which 6088 had private insurance, 756 had Medicaid, 4536 had Medicare, and 481 are uninsured. Privately insured patients were more likely to present at an early stage (p < .001). On multivariate Cox regression analysis, privately insured patients had significantly longer OS than patients with Medicaid (HR: 1.936, 95% CI: 1.680–2.230, p < .001), Medicare (HR: 1.342, 95% CI: 1.222–1.474, p < .001), or no insurance (HR 1.849, 95% CI: 1.539–2.222, p < .001). The survival advantage of privately insured patients persisted on relative survival and propensity score-matched analyses. In conclusion, privately insured patients were more likely to present at an early stage, and had longer OS than patients who were Medicaid-, Medicare-, or not insured.

Keywords:

• Cutaneous T-cell lymphoma
• insurance status
• socioeconomic factors
• survival analysis
• National Cancer Database