The National Cancer Database, a hospital based registry sponsored by the American College of Surgeons and the American Cancer Society, is the only national registry that collects information on patient insurance status.

The ACS report has found that the uninsured are less likely to get the recommended cancer screening tests, are more likely to be diagnosed with cancer at more advanced stages, and have lower survival rates than those with private insurance for several cancers.

Although advances in prevention, early detection, and treatment of cancer have resulted in an almost 14 percent drop in the death rates from all cancers combined from 1991 to 2004 in the U.S., not everyone in America has benefited equally from this progress. The evidence suggests that some of these differences are related to lack of access to health care, particularly the lack of insurance or inadequate insurance, which appears to be a critical obstacle in receiving appropriate health care services.

"The findings of this major study are critical, not only for the 47 million Americans who have no health insurance, but also for our nation," said Dr. John R. Seffrin, chief executive officer of the American Cancer Society.

"The fact is, too many cancer patients are being diagnosed too late, when treatment is harder, more expensive, and has less chance of saving lives. We must begin to remove the barriers that stand in the way of early diagnosis and timely access to medical care if we are to give all cancer patients an equal chance in the fight."

Some of the report findings:

• Among individuals under age 65, those aged 18 to 24 have the highest probability of being uninsured.
• The probability of being uninsured varies inversely by income.
• More than half (53.6 percent) of uninsured individuals aged 18 to 64 years have no usual source of health care.
• The uninsured are more likely to report that costs issues caused them to delay care, not receive care, and not obtain prescription drugs.
• For all cancer sites combined, patients who were uninsured were 1.6 times as likely to die in five years as those with private insurance.

"This report clearly indicates that insurance and cost-related barriers are critical to address if we want to ensure that all Americans are able to share in the progress we have achieved by having access to high-quality cancer prevention, detection, and treatment services," said Dr. Otis Brawley, chief medical officer of the Society.

In 2007, ACS launched the Access to Care campaign, a national initiative dedicated to raising awareness about the troubles of uninsured and underinsured people in the U.S. The campaign encourages people to get involved in finding ways to fix the problem and make access to care a national priority. For more information, visit www.cancer.org/access.

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