Estimating the Uninsured Cancer Rate: Unraveling the Indelible Link Between Insurance, Age, and the Accessibility of Cancer Treatment.

Introduction: Patients without insurance often wait until their symptoms become severe before seeking treatment. While done to avoid the cost of preventative care, this decision leads to uninsured patients presenting with more advanced diseases. This trend can be clearly seen in cancer care. Research shows that uninsured adults are less likely to receive cancer screenings than their insured counterparts, more likely to be diagnosed with cancer at a later stage and have an increased risk for death for certain types of cancer.

Hypothesis: We aim to calculate the overall uninsured rate for cancer patients across The University of Kansas Cancer Center's (KUCC) catchment area and estimate the uninsured rate for patients treated within a large health system in the state of Kansas.

Methods: A literature review was conducted to collect the uninsured rates for Kansas and Missouri by age group. Three datasets were used to generate an overall uninsured rate for both states for the age groups of 0-19, 20-64, and 65 or older. The cancer incidence was derived using the 2020 estimated number of KUCC cases and the mean percentage of 2015-2019 cases for the corresponding age groups. The estimated uninsured and cancer incidence rates were then used to calculate the overall uninsured cancer rate.

Results: The total number of estimated 2020 KUCC cases was 24,412, with 0.86%, 42.56%, and 56.58% being the percentage per the age groups 0-19, 20-64, and 65+. The estimated uninsured rate per age group was 5.33%, 13.49%, and 0.40%. Based on these results, there were an estimated number of 11 uninsured cancer patients in the MCA area between the ages of 0-19, 1,401 between the ages of 20-64, and 55 uninsured cancer patients over the age of 65. This yielded an overall uninsured cancer rate of 6.01%.