Impact of insurance status on the survival of gallbladder cancer patients
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Zhiqiang Chen1,*, Wen Gao2,*, Liyong Pu1,*, Long Zhang1, Guoyong Han1, Qin Zhu1, Xiangcheng Li1, Jindao Wu1 and Xuehao Wang1
1Department of Liver Surgery, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory on Living Donor Liver Transplantation, National Health and Family Planning Commission, Nanjing, Jiangsu Province, China
2Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
*These authors have contributed equally to the work
Xuehao Wang, email: firstname.lastname@example.org
Jindao Wu, email: email@example.com
Xiangcheng Li, email: firstname.lastname@example.org
Keywords: gallbladder cancer, insurance status, SEER, survival analysis
Received: March 29, 2017 Accepted: May 06, 2017 Published: June 06, 2017
The prognostic significance of insurance status has been investigated in many types of malignancies, however, its impact on gallbladder cancer is yet not known. The purpose of this study was to determine the relationship between insurance status and gallbladder cancer survival. We searched the Surveillance, Epidemiology, and End Results dataset, and identified 1,729 gallbladder cancer cases. Kaplan–Meier methods and multivariable Cox regression models were used to analyze survival outcomes and risk factors. We found that individuals who had non-Medicaid insurance were more likely to be male, older, from wealthier area, and better-educated. Insurance status was confirmed as an independent prognostic factor for gallbladder cancer patients. Stratified analysis revealed that the uninsured status independently predicted unfavorable survival outcome at localized tumor stage and in white individuals. To conclude, insurance status is an important predictive factor for gallbladder cancer, and uninsured individuals are at the highest risk of death.
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