之前使用 2000 年代初的数据研究表明，在美国，没有医疗保险的患者更容易出现晚期癌症，并在癌症诊断后短期生存率较差。本报告提供了关于健康保险覆盖类型与诊断阶段和长期生存之间的关联的全面数据，在 2010 年至 2013 年被诊断出 19 种常见癌症并在全国癌症数据库中实行随访，至 2019 年 12 月 31 日。与私人医疗保险被覆盖的患者相比，被 Medicaid 医疗保险覆盖和没有医疗保险的患者在所有可分期癌症和分开的癌症中被诊断为晚期（III/IV）癌症的可能性显着增加。对于所有可分期癌症和六种癌症部位 - 前列腺、结直肠、非霍奇金淋巴瘤、口腔、肝脏和食管，未被私人医疗保险覆盖的患者，即使被诊断为 I 期的癌症，生存率也比被私人医疗保险覆盖的患者诊断为 II 期的癌症差。没有私人医疗保险覆盖的患者在所有癌症中每个阶段的短期和长期生存率较差；没有医疗保险的患者在 17 种可分阶段癌症中有 12 种的阶段特异性生存率较差，而对于白血病和脑肿瘤，生存率也较差。扩大全面健康保险覆盖的接触对于改善癌症护理和结果非常关键，包括诊断阶段和生存率。© 2022 The Authors. Wiley Periodicals LLC 代表美国癌症协会出版的 CA: A Cancer Journal for Clinicians。

Previous studies using data from the early 2000s demonstrated that patients who were uninsured were more likely to present with late-stage disease and had worse short-term survival after cancer diagnosis in the United States. In this report, the authors provide comprehensive data on the associations of health insurance coverage type with stage at diagnosis and long-term survival in individuals aged 18-64 years who were diagnosed between 2010 and 2013 with 19 common cancers from the National Cancer Database, with survival follow-up through December 31, 2019. Compared with privately insured patients, Medicaid-insured and uninsured patients were significantly more likely to be diagnosed with late-stage (III/IV) cancer for all stageable cancers combined and separately. For all stageable cancers combined and for six cancer sites-prostate, colorectal, non-Hodgkin lymphoma, oral cavity, liver, and esophagus-uninsured patients with Stage I disease had worse survival than privately insured patients with Stage II disease. Patients without private insurance coverage had worse short-term and long-term survival at each stage for all cancers combined; patients who were uninsured had worse stage-specific survival for 12 of 17 stageable cancers and had worse survival for leukemia and brain tumors. Expanding access to comprehensive health insurance coverage is crucial for improving access to cancer care and outcomes, including stage at diagnosis and survival.© 2022 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.