
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, July 29, 1993                   TAG: 9307290003
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A3   EDITION: NEW RIVER VALLEY 
SOURCE: Associated Press
DATELINE: BOSTON                                LENGTH: Medium

PRIVATE INSURANCE BOON TO PATIENTS

Breast cancer victims who have private insurance tend to learn of their disease at earlier stages and survive longer after the diagnosis than do women with Medicaid or no coverage, a study found.

Many studies have shown that patients with private insurance get more intense medical care than do other people. However, few have attempted to learn whether this increased care actually translates into better health.

The latest study suggests that breast cancer patients with private insurance are better off, but it does not prove that they live any longer as a result of their earlier treatment.

The researchers acknowledge that social class differences could also play a role. Those with private insurance may be more health conscious and more likely to get checked when they suspect early signs of cancer.

Dr. John Z. Ayanian of Brigham and Women's Hospital in Boston, who directed the analysis, said he believes privately insured women may do better because they have easier access to mammograms and breast exams.

"We know from previous surveys that patients without health insurance or coverage by Medicaid are less likely to receive cancer screening services," he said. "After cancer diagnosis, they may be less completely evaluated and treated."

The latest study, Ayanian said, "takes the next step to show there are real differences in the outcomes of breast cancer. What we need to do now is develop a better understanding of what the best way of improving these outcomes would be." The study, published in today's New England Journal of Medicine, was based on a review of 4,675 women under age 65 who were diagnosed with breast cancer over a two-year period in New Jersey.

During four to seven years after their diagnoses, they found that uninsured women had a 49 percent higher risk of death, and women on Medicaid had a 40 percent higher risk of dying. However, they cautioned this could be partially explained by the insured women's earlier diagnoses. Because their cancer was spotted sooner, their survival might seem to be longer, even if earlier treatment did not actually prolong their lives.

by CNB