Work

Association Between Insurance Status and Nonelderly Penile Squamous Cell Carcinoma Survivorship: A National Retrospective Analysis

Year: 2024

Type: article

Abstract: Background: Penile squamous cell carcinoma is an aggressive genitourinary malignancy with significant physical and psychological morbidity. Socioeconomic factors are prognostic indicators for various genitourinary neoplasms. Therefore, investigating the association between penile squamous cell cancer survivorship based on insurance status holds considerable implications for reducing cancer burden and maximizing health equity in the varying social gradients. Materials and Methods: Men diagnosed with primary penile squamous cell carcinoma from 2007 to 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) national database. Participants were categorized based on insurance status: non-Medicaid, Medicaid, and uninsured. Pearson’s chi-squared test assessed the distribution of observed frequencies between the patient demographics, socioeconomic status, tumor characteristics, and surgical variables across the insurance groups. Overall and penile cause-specific survival was estimated using a multivariate Cox hazards proportional model analysis. Results: The multivariate Cox hazards proportional model showed that, compared to non-Medicaid insured patients, Medicaid patients had an increased risk for overall death (hazard ratio [HR] = HR 1.54; 95% CI, 1.12–2.07). For penile cause-specific mortality, Medicaid patients had an increased risk of death compared to non-Medicaid insured patients (HR 1.58; 95% CI, 1.11–2.25). Conclusion: Medicaid does not mitigate the differences caused by health insurance status due to health insurance disparities for overall or penile cause-specific mortality. Lower Medicaid reimbursements and out-of-pocket costs lead to a narrow network of physicians, hospitals, and treatment modalities that compromise health equity. Increasing awareness of health insurance disparities and improving access to care via a clinician-community-governmental partnership can potentially lead to improved predictive outcomes.

Source: Uro

DOI: 10.3390/uro4040014

Authors: Nikit Venishetty, Yousef Rafati, Laith Alzweri

Institutions: Texas Tech University, The University of Texas Medical Branch at Galveston

Language: English

Topic: Genital Health and Disease

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $1,137