Health insurance status and survival among patients with head and neck cancer in Japan

Takenaka, Yukinori; Yasui, Toshimichi; Enomoto, Keisuke; Miyabe, Haruka; Morizane, Natsue; Ashida, Noboru; Shimizu, Ken D.; Hirose, Masayuki; Yamamoto, Yoshihiko; Uno, Atsuhiko

doi:10.1007/s10147-015-0921-5

Cited by 10 publications

(9 citation statements)

References 19 publications

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“…Despite diagnostic advances and improvements in treatment modalities, the 5-year survival rate of such patients remains poor (2). HNSCC represents a wide spectrum of neoplasms with different patterns of biological behaviour (3) therefore, the current tumor classification is limited in its prediction of prognosis.…”

Section: Introductionmentioning

confidence: 99%

The prognostic significance of estrogen receptor β in head and neck squamous cell carcinoma

et al. 2016

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Head and neck squamous cell carcinoma (HNSCC) is the fifth most common cancer in the world. Although multimodal and targeted therapy is now used in therapeutic procedures, the survival of patients with HNSCC has remained unchanged over the last 30 years. A number of studies have demonstrated that the increased expression of intranuclear ERβ in breast, lung and colon cancer is a favorable prognostic marker associated with higher survival rates. However, the clinical significance of sex hormone receptors in HNSCC remains unclear. The current study aimed to assess the expression of ERβ in HNSCC immunohistochemically and investigate any possible association between ERβ expression, and clinical and histopathological factors, disease recurrence and patient survival. The present study included 174 patients (165 males and 9 females) with a median age of 60.8 years (range, 39–79) with HNSCC who were primary surgically treated between January 2000 and December 2006. Immunohistochemical reactions for ERβ demonstrated that 73 patients (42%) exhibited positive ERβ expression. Distribution of ERβ status among different head and neck subsites indicated that >40% of all negative cases were located in laryngeal primaries, while incidence of other sublocalization within positive cases was similar and comparable (P=0.04). Furthermore, a correlation was observed between ERβ immunopositivity and the survival of patients, with respect to the primary tumor site. Patients with ERβ positive oropharyngeal cancer had a survival rate of 35.3% at 5-years compared with 25% for patients with negative expression. However, ERβ status was not significantly correlated with any other clinical or histopathological parameter. After an average follow-up time of 38.5 months (range, 3–60 months), 54 patients (31.1%) had succumbed to disease recurrence while 50 (28.7%) succumbed to other causes. In conclusion, ERβ positivity indicates improved survival of patients with oropharyngeal cancer. Further research is required in order to implement novel therapeutic strategies.

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Section: Introductionmentioning

confidence: 99%

The prognostic significance of estrogen receptor β in head and neck squamous cell carcinoma

et al. 2016

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“…We held the view that late initiating treatment, inadequate treatment and poor physical conditions might contribute to the poor prognosis of young CRC patients with Medicaid. Previous studies have reported the prognostic effect of insurance status in many cancers, and Medicaid or uninsured patients would have worse survival compared with insured ones (18)(19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

Clinical Implications of Nonbiological Factors With Colorectal Cancer Patients Younger Than 45 Years

Liu

Zhang

et al. 2021

Front. Oncol.

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BackgroundTo evaluate the clinical implications of non-biological factors (NBFs) with colorectal cancer (CRC) patients younger than 45 years.MethodsIn the present study, we have conducted Cox proportional hazard regression analyses to evaluate the prognosis of different prognostic factors, the hazard ratios (HRs) were shown with 95% confidence intervals (CIs). Kaplan–Meier method was utilized to compare the prognostic value of different factors with the log-rank test. NBF score was established according to the result of multivariate Cox analyses.ResultsIn total, 15129 patients before 45 years with known NBFs were identified from the SEER database. Only county-level median household income, marital status and insurance status were NBFs that significantly corelated with the cause specifical survival in CRC patients aged less than 45 years old (P < 0.05). Stage NBF 1 showed 50.5% increased risk of CRC-specific mortality (HR = 1.505, 95% CI = 1.411-1.606, P < 0.001). Stage NBF 0 patients were associated with significantly increased CRC-specific survival (CCSS) when compared with the stage NBF 1 patients in different AJCC TNM stages.ConclusionsNBF stage (defined by county-level median household income, marital status and insurance status) was strongly related to the prognosis of CRC patients. NBFs should arouse enough attention of us in clinical practice of patients younger than 45 years.

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“…Regarding different healthcare systems worldwide, results differ significantly. Particularly in countries without compulsory insurance, uninsured patients show significantly increased tumour stages at diagnosis and poor survival [2][3][4][5][6]. In Germany, there is a long tradition of compulsory insurance.…”

Section: Discussionmentioning

confidence: 99%

“…Particularly, in countries without compulsory insurance, uninsured patients show advanced tumour stages at the time of diagnosis, hence poor survival [2][3][4][5]. Other countries such as Japan did not observe differences in survival parameters with the insurance status [6]. In Germany, there is a long history of compulsory insurance attributed to Bismarck's governmental decision in 1883.…”

Section: Introductionmentioning

confidence: 96%

Mono-institutional retrospective cohort analysis of the insurance status dependent access to ENT-professionals and survival in head and neck squamous cell carcinoma

Knopf

Teutsch²,

Bier³

2021

BMC Health Serv Res

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Background To access the influence of insurance status on time of diagnosis, quality of treatment and survival in head and neck squamous cell carcinoma (HNSCC). Methods This mono-institutional retrospective cohort analysis included all HNSCC patients (n = 1,054) treated between 2001 and 2011, and subdivided the cohort according to the insurance status. Differences between the groups were analyzed using the Chi square and the unpaired student’s t-test. Survival rates were calculated by Kaplan-Meier and Cox regression for forward selection. Results Nine hundred twenty-five patients showed general, 129 private insurance. The 2 groups were equal regarding age, gender, tumor localization, therapy, and N/M/G/R-status. The T-status differed significantly between the groups showing more advanced tumors in patients with general insurance (p = 0.002). While recurrence-free survival was comparable in both groups, overall survival was significantly better in private patients (p = 0.009). The time frame between first symptom and diagnosis was equal in both groups. Conclusions The time frame between subjective percipience of first symptom and final therapy did not differ between the groups. In our cohort, access to otorhinolaryngological specialists is favorable in both, patients with general and private insurance. Recurrence-free survival was comparable in both groups, indicating successful HNSCC treatment both groups. However, overall survival was significantly better in patients with private insurance suggesting other socioeconomic factors influencing survival.

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Health insurance status and survival among patients with head and neck cancer in Japan

Abstract: The demonstrated non-inferiority of public assistance regarding HNSCC-specific mortality indicates the equality of healthcare in Japan, irrespective of the insurance status, and the superiority of the Japanese healthcare system.

Cited by 10 publications

References 19 publications

The prognostic significance of estrogen receptor β in head and neck squamous cell carcinoma

The prognostic significance of estrogen receptor β in head and neck squamous cell carcinoma

Clinical Implications of Nonbiological Factors With Colorectal Cancer Patients Younger Than 45 Years

Mono-institutional retrospective cohort analysis of the insurance status dependent access to ENT-professionals and survival in head and neck squamous cell carcinoma

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