Insurance status is an independent predictor of overall survival in patients with stage III non-small cell lung cancer treated with curative intent

Abstract Introduction Population studies suggest an impact of insurance status on oncological outcomes. We sought to explore this in a large single-institution cohort of non-small cell lung cancer (NSCLC) patients. Materials and Methods We retrospectively analyzed 342 consecutive patients (January 2000 - December 2013) curatively treated for stage III NSCLC. Patients were categorized by insurance status as uninsured (U), Medicare/Medicaid + Veterans Affairs (M/M+VA), or Private (P)]. Chi-square was utilized to compare categorical variables. The Kaplan-Meier approach and the Cox proportional hazard models were used to analyze overall survival (OS) and freedom-from-recurrence (FFR). Results Compared to M/M+VA, P insurance patients were more likely to be younger (p 30 days in U (67.3%), M/M+VA (68.1%) and P (52.6%) patients (p=0.017). Compared to M/M+VA and U cohorts, P insurance patients had improved OS (Median/5-year: 30.7m/34.2%, 19m/17% and 16.9m/3.8%, p Conclusion Compared to U or M/M+VA, P insurance Stage III NSCLC patients were more likely to be optimally diagnosed and treated resulting in a doubling of median OS for P vs U patients. Improved access to affordable health insurance is critical to combat inequities in access to care and has potential for improvements in cancer outcomes.