National Healthcare Disparities Report - LDI Health Economist

Effectiveness of Care
Chapter 2 Cancer
NEW
n From 2000 to 2008, the percentage of non-Hispanic White women ages 50-74 who reported they
had a mammogram in the past 2 years fell from 79% to 74%. There were no statistically significant
changes in rates among other racial and ethnic groups (Figure 2.1).
n Asian women were less likely to have a mammogram than White women and Hispanic women were
less likely to have a mammogram than non-Hispanic White women in all years except 2008.
n The 2008 top 5 State achievable benchmark was 88%. iv There is no evidence of progress toward the
benchmark by any racial or ethnic group.
Also, in the NHQR:
n In all years, among women ages 50-64, uninsured women were less likely to have a mammogram
than those with private insurance. Among women ages 65-74, those with Medicare only were less
likely to have a mammogram than those with Medicare and any private supplemental insurance.
Medicare does not cover all health care costs. Medicare beneficiaries can purchase private
supplemental insurance from insurance companies to help pay for coinsurance, copayments, and
deductibles. Beneficiaries with Medicare only typically must pay out of pocket for costs not covered
by Medicare.
Outcome: Breast Cancer First Diagnosed at Advanced Stage
Cancers can be diagnosed at different stages of development. Cancers diagnosed early before spread has
occurred are generally more amenable to treatment and cure; cancers diagnosed late with extensive spread
often have poor prognoses. The rate of cancer cases diagnosed at advanced stages is a measure of the
effectiveness of cancer screening efforts and of adherence to followup care after a positive screening test.
Because many cancers often take years to develop, changes in rates of late-stage cancer may lag behind
changes in screening rates.
In past reports, rates of advanced stage cancer from the National Cancer Institute’s Surveillance,
Epidemiology, and End Results (SEER) program were reported. Estimates for the Nation were based on 13
SEER areas encompassing about 26% of the U.S. population. Beginning in the 2011 NHQR and NHDR,
data from the SEER program and the National Program on Cancer Registries were combined to calculate
national statistics on rates of advanced stage cancer. Together, the SEER program and the National Program
on Cancer Registries collect cancer data for the entire U.S. population.
iv
The top 5 States contributing to the achievable benchmark are Connecticut, Delaware, Massachusetts, New Hampshire, and Rhode
Island.
52 National Healthcare Disparities Report, 2011