Lack of insurance was found to be associated with suboptimal survival outcomes in patients with gastric cancer, according to results from a retrospective study presented at the 2020 American College of Gastroenterology Annual Scientific Meeting.

Researchers conducted a retrospective study to assess the impact of insurance status on survival outcomes in patients with gastric cancer. At a follow-up of 13 months, the mean survival time among the study’s 111 patients was 7 months. No insurance (P =.012) was the most significant risk factor for poor survival outcomes, followed by Medicaid insurance coverage (P =.046). The findings validate a trend that has been witnessed not only in gastric cancer but also across tumor types: uninsured patients tend to present with malignancies later than patients with insurance and therefore have worse survival outcomes due to the advanced stage of disease.

Notably, most patients (69.4%) included in the study were uninsured. Medicaid was the most common insurance coverage among those insured (11.7%), followed by private insurance (9.9%) and Medicare (9.0%). Regarding patient characteristics, 70.3% of the study population was Hispanic, and 60.4% were not US citizens. Most patients (76.6%) had late-stage disease.

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The population included patients who were diagnosed with gastric cancer between 2010 and 2019 and were seen at Creighton University School of Medicine in Phoenix, Arizona. Specifically, 55% of patients were found to have diffuse-type adenocarcinoma.

Although the incidence of gastric cancer is decreasing nationally, it remains high globally and in select populations, according to Forlemu et al. Insurance status, along with race and poverty, might contribute to disease prevalence; therefore, “heightened recognition of the importance of insurance coverage is imperative in order to improve outcomes” in patients with gastric cancer,” the study authors concluded.


Forlemu AN, Findakly D, Kosa D, Amar S. Real-world survival outcomes of gastric cancer based on insurance status; evidence from a large single-center study. Presented at: the 2020 American College of Gastroenterology Annual Scientific Meeting; October 26-28, 2020. Abstract S1370.