Abstract P1-10-11: Outcome of Patients with Early Breast Cancer Is Not Related to Their State of Social or Health Insurance

Abstract

Background: Recent studies in the US showed a relationship between the state of social or health insurance of cancer patients and their overall survival. [1-3] In Germany 91% of all women are estimated to have a compulsory health insurance whereas 9% have private health coverage. There are no patients without any health insurance in Germany. Patients and Methods: In a retrospective analysis of 1846 german patients with early breast cancer the correlation between state of social and health insurance and overall survival was investigated. 59.6% of the patients had a social insurance whereas 40.4% had none. 69.1% of the patients carried compulsory health insurance while 30.9% had private coverage. Among the patients with compulsory health insurance 56.6% had had a professional education and 41.5% were employed whereas among the patients with private coverage 66.2% were professionally experienced and 43.9% were working. Age, tumor size, lymph node metastases, grading and both hormone and her2-status were well balanced between the two groups. 25.4% of all patients had undergone mastectomy and 72.6% had had a breast conserving therapy. In 2.0% of the patients no surgery was performed. 33.6% of all patients received adjuvant chemotherapy while endocrine therapy or radiotherapy was administered to 40.1% and 61.1% respectively. Results: Overall survival as expected was strongly correlated to established prognostic factors such as age, tumor size, lymph node status, and grading (p< 0.001) respectively. However, overall survival of the patients did not correlate to either social (p= 0.110) or health (p= 0.659) insurance state. Neither did the professional education of the patients play a role concerning overall survival (p= 0. 217.. Conclusions: Unlike the American results there was no correlation seen between state of social or health insurance for german early breast cancer patients. Thus, although patients with private coverage are supposed to receive more intensive medical care, outcome for these patients concerning overall survival is not better than for patients with compulsory insurance. Literature: 1. Banerjee M, George J, Yee C, Hryniuk W, Schwartz K.: Disentangling the effects of race on breast cancer treatment. Cancer. 2007 Nov 15;110(10):2169-77. 2. Griggs JJ, Culakova E, Sorbero ME, Poniewierski MS, Wolff DA, Crawford J, Dale DC, Lyman GH. Social and racial differences in selection of breast cancer adjuvant chemotherapy regimens. J Clin Oncol. 2007 Jun 20;25(18):2522-7. 3. Brookfield KF, Cheung MC, Lucci J, Fleming LE, Koniaris LG. Disparities in survival among women with invasive cervical cancer : a problem of access to care. Cancer. 2008 Dec 18. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-10-11.