Patients with Medicaid, no insurance may face barriers in access to uveal melanoma care
Click Here to Manage Email Alerts
Key takeaways:
- Brachytherapy was the most common treatment for patients with uveal melanoma.
- Patients with Medicaid or no insurance were more likely to be diagnosed with later-stage uveal melanoma.
CARLSBAD, Calif. — Patients with uveal melanoma who had Medicaid or no insurance were less likely to receive brachytherapy and more likely to be diagnosed at later stages, according to a study presented here.
The findings suggest these patients likely face barriers in access to care, researchers wrote in a poster presented at the Women in Ophthalmology Summer Symposium.
“Uveal melanoma is a rare, primary intraocular cancer that only a select number of specialists and treatment centers are equipped to treat,” Victoria A. Marks, MD, of Yale School of Medicine and Bascom Palmer Eye Institute, and colleagues wrote. “Access to uveal melanoma care, and influencing factors, are therefore important considerations.”
To investigate associations related to insurance status, uveal melanoma care and survival outcomes in the U.S., Marks and colleagues analyzed data from 7,677 patients in the National Cancer Database who were diagnosed with uveal melanoma and treated with enucleation/surgical resection, brachytherapy or other methods between 2004 and 2017.
Over the course of the study period, brachytherapy, which the researchers noted is the preferred treatment type for clinically appropriate tumors, was the most common treatment modality.
However, the researchers found that compared with patients with private insurance, those with Medicare (OR = 0.758; 95% CI, 0.617-0.93), Medicaid (OR = 0.459; 95% CI, 0.326-0.647) or no insurance (OR = 0.565; 95% CI, 0.371-0.863) were less likely to be treated with brachytherapy.
Instead, those patients were more likely to undergo enucleation/resection (Medicare: OR = 1.389; 95% CI, 1.091-1.767; Medicaid: OR = 2.268; 95% CI, 1.599-3.216; uninsured: OR = 2.549; 95% CI, 1.666-3.899).
In addition, patients with Medicaid or no insurance likely faced barriers in access to uveal melanoma care, resulting in later-stage disease presentation.
At diagnosis, patients with Medicaid were more likely to have stage 4 uveal melanoma (OR = 1.971; 95% CI, 1.23-3.156) and patients with no insurance were more likely to be diagnosed at stage 3 (OR = 2.053; 95% CI, 1.229-3.429) or stage 4 (OR= 2.01; 95% CI, 1.131-3.572) compared with patients with private insurance.
“Future efforts should focus on increased accessibility to regular eye care,” Marks and colleagues wrote.
Collapse
Marks VA, et al. Association between health insurance, access to care, and outcomes for patients with uveal melanoma in the United States. Presented at: Women in Ophthalmology Summer Symposium; Aug. 22-25, 2024; Carlsbad, California.
Read more about
Click Here to Manage Email Alerts