ONS Connect - April 2008 - (Page 6)

JUSTIN [By Deborah McBride, RN, MSN, CPON ®, Contributing Editor] Insurance Status may Be Linked to Cancer Outcomes L Childhood Cancer Death Rates Decline Overall O verall childhood cancer death rates decreased significantly from 1990– 2004, according to researchers from the U.S. Centers for Disease Control and Prevention. According to the report, cancer death rates decreased in boys and girls, children and adolescents, most racial and ethnic groups, and all U.S. Census regions. The researchers used data from the U.S. National Vital Statistics System, adjusted for population growth, to identify 27.3 cancer deaths per million children and adolescents in 2004 versus 34.2 deaths per million in those age groups in 1990. Leukemia was the leading cause of childhood cancer deaths in 2004, followed by brain and other nervous system cancers. From 1990–2004, death rates declined by 3% per year APRIL 2008 for leukemias, 1% per year for brain and other nervous system cancers, and 1.3% per year for all other cancers combined. At the same time, the incidence rates for all childhood cancers increased by 0.6% per year from 1975–2002, primarily as a result of population growth. Hispanics and non-Hispanics had similar childhood cancer death rates in 1990, but the rates declined more rapidly for non-Hispanics from 1990– 2004. The researchers said that lack of health insurance and access to health care may be factors in the disparity, but differences in tumor aggressiveness, cancer stage at diagnosis, and response to treatment also should be considered. U.S. Centers for Disease Control and Prevention. (2007). Trends in childhood cancer mortality—United States, 1990–2004. Morbidity and Mortality Weekly Report, 56(48), 1257–1261. ack of adequate health insurance coverage may be associated with less access to care and poorer outcomes for patients with cancer, according to a new report from the American Cancer Society. The report finds that the uninsured are less likely to receive recommended cancer screening tests, are more likely to be diagnosed with later-stage disease, and have lower survival rates than those with private insurance. Death rates from all cancers combined have dropped by almost 14% in the United States from 1991–2004 because of advances in the prevention, early detection, and treatment of cancer. However, not all segments of the population saw an equal reduction. Lack of access to health care and, in particular, lack of health insurance or inadequate health insurance appear to be barriers to receipt of healthcare services. The report found that for all cancers, uninsured patients were 1.6 times more likely to die in five years than those with private insurance. The relationship between access to care and cancer outcomes is particularly striking for several types of cancers that can be prevented or detected early by screening and for which effective treatments are available, such as breast and colorectal cancers. Individuals with health insurance were about twice as likely as those without health insurance to have had mammography or colorectal cancer screening. Ward, D., Halpern, M., Schrag, N., Cokkinides, V., DeSantis, C., Bandi, P., et al. (2008). Association of insurance with cancer care utilization and outcomes. CA: A Cancer Journal for Clinicians, 58(1), 9–31. 6 ONS CONNECT

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ONS Connect - April 2008 Contents Editor's Note Just In Work-Life Balance A Year in the Life—Month Four Web Connect Capitol Connection Notice Nursing Now Enhance Your Professionalism in Your Daily Practice Help Patients Integrate Yoga Into Cancer Care Caregiver Care Epigenetics Offers New Options for Cancer Diagnosis Working for You Calendar of Events Staying on Top

ONS Connect - April 2008

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