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Study Implies Many Delay Cancer Screenings Until Eligible for Medicare

Study Implies Many Delay Cancer Screenings Until Eligible for Medicare
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Published on April 13, 2021

Cancer Diagnoses Increase Nationwide at the Age of Medicare Eligibility

Stanford University researchers have found a significant increase nationwide in the number of people aged 65 and older who are diagnosed with cancer, suggesting that many delay screenings until they are eligible for Medicare.

The study published last month in the journal Cancer was sparked by Dr. Joseph Shrager, a professor of cardiothoracic surgery at Stanford School of Medicine. He noticed his patients were being diagnosed with lung cancer at a surprisingly higher rate at age 65. His thoracic surgeon colleagues were seeing a similar trend.

“There was no reason rates should differ much between the ages of 63 and 65,” Dr. Shrager said in a press release. He and his colleagues questioned whether patients were delaying care until Medicare kicked in at 65. “If this were true, and patients were delaying screenings or treatments for cancer, it could impact their survival.”

An exploratory analysis of the surgeons’ own practices showed a twofold increase in lung cancer surgeries in 65-year-old patients compared to those aged 64.

In their follow-up study, they found a jump in new cancer diagnoses at age 65 for lung, breast, colon and prostate cancer — the most common cancers in the United States. The greatest difference for all four cancers was seen in stage I diagnoses.

Study Details

Researchers analyzed data from patients between the ages of 61 and 69 who were diagnosed with lung, breast, colon or prostate cancer from 2004 to 2016. The patients included 134,991 with lung cancer, 175,558 with breast cancer, 62,721 with colon cancer and 238,823 with prostate cancer.

Lung cancer rates showed a consistent increase of 3-4% each year for people aged 61 to 64, then at age 65 that percentage doubled. The increase was even more pronounced in colon cancer diagnoses: an annual growth rate of just 1-2% in the years leading up to Medicare eligibility, then a jump to nearly 15% at 65. In the years following age 65, diagnosis rates declined for all cancers.

The study also found that the insured post‐Medicare group was more likely to undergo treatment and less likely to die from their cancer than their younger, uninsured counterparts. This implies Medicare eligibility is associated with more early-stage diagnoses, resulting in longer lives.

Researchers pointed to several factors that cause 61- to 64-year-olds to delay medical treatments and screening, including a lack of insurance as a result of early retirement, pre-existing conditions hindering renewal and the high cost of private insurance. The study notes that 13-25% of people are uninsured or have a gap in medical coverage at some point preceding Medicare eligibility.

“If you don’t get the right screening or prompt diagnosis you are going to have lower cure rates,” Dr. Shrager said in the release. “This study underlines the important difference that some sort of Medicare expansion could make.”

Bottom Line

Diagnosing cancer at its earliest stages often provides the best chance for a cure. If you are unable to pay for cancer screening or treatment, there are several programs available to help. Even if you are in a higher-income bracket, you may be eligible for financial assistance.

Check out Patient Power’s list of financial resources.

See the American Cancer Society’s guidelines for the early detection of cancer.

~Megan Trusdell

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