Researchers at Shannxi Normal University Describe Findings in Cancer (Association of insurance status among cancer patients and survival outcomes: a systematic review and meta-analysis): Cancer

2025 OCT 16 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Cancer. According to news originating from Xi’an, People’s Republic of China, by NewsRx correspondents, research stated, “Health insurance coverage is a critical determinant of cancer care access. However, the association of different insurance statuses affecting survival outcomes remains understudied worldwide.”

Our news journalists obtained a quote from the research from Shannxi Normal University, “This meta-analysis provides global evidence on the association between insurance status and survival and highlights structural health inequities across national health insurance systems. We searched five databases for cohort studies published between 1 January 2000 and 15 July 2025. Random-effect multilevel and traditional meta-analyses were employed to address heterogeneity. The Newcastle-Ottawa Scale (NOS) and the ROBINS-I method assessed all studies for quality. We included 37 studies between 2000 and 2025, contributing 219 effect sizes. In the United States (US), patients insured in Medicare (HR: 1.29, 95% CI: 1.17-1.42, P< 0.001; t = 0.046, I = 67.28%; t = 0.022, I = 31.89%), Medicaid (HR: 1.39; 95% CI: 1.28-1.51, P< 0.001; t = 0.049, I = 74.07%; t = 0.016, I = 24.60%), or without insurance (HR: 1.42, 95% CI: 1.31-1.53, P = 0.001; t = 0.032, I = 65.99%; t = 0.015, I = 30.77%) had worse overall survival (OS) than private insurers. Cancer stage, cancer type, and the adjustment variables are moderators of effect size heterogeneity in the US. The association between insurance status and survival was stronger in early-stage (I-II) cancers and among patients with breast and prostate cancer, whereas survival disparity across insurance statuses was smaller or not statistically significant for advanced (III-IV) stages and patients diagnosed with lung, liver, and colorectal cancer. In China, patients without Urban Employee Basic Medical Insurance (non-UEBMI) showed worse OS (HR: 1.39; 95% CI: 1.22-1.59; I = 60.0%; t = 0.012) than UEBMI patients. Qualitative evidence from Germany, South Korea, Thailand, and Brazil did not identify statistically significant associations between insurance status and cancer survival outcomes. Uninsured individuals were experiencing poorer OS than those with any other form of insurance status globally. The association between insurance status and cancer survival differs across national health insurance systems. Insurance policies should prioritize early-stage cancer care, cancer types with a favorable prognosis, and uninsured groups.”

According to the news editors, the research concluded: “Future research should use prospective international cohorts to explore how insurance structures and covariate interactions affect survival and to achieve equity in global cancer care.”

For more information on this research see: Association of insurance status among cancer patients and survival outcomes: a systematic review and meta-analysis. International Journal for Equity in Health, 2025;24(1):265. International Journal for Equity in Health can be contacted at: Bmc, Campus, 4 Crinan St, London N1 9XW, England. (BioMed Central - http://www.biomedcentral.com/; International Journal for Equity in Health - www.equityhealthj.com)

The news correspondents report that additional information may be obtained from Jiayang Kong, School of Psychology, Shannxi Normal University, Xian, 710062, People’s Republic of China. Additional authors for this research include Jiashuai Tian, Na Zhou, Liliang Zhang, Xinyu Cai, Dai Su and Guangying Gao.

The publisher’s contact information for the International Journal for Equity in Health is: Bmc, Campus, 4 Crinan St, London N1 9XW, England.

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