Abstract A082: Contribution of health insurance to racial and ethnic disparities in advanced stage diagnosis of 10 cancers

Abstract For many cancer sites, it is unclear to what extent differences in health insurance coverage contribute to racial and ethnic disparities in stage III-IV diagnoses. Using the National Cancer Database (1,893,026 patients aged 18-64 years, diagnosed between 2013-2019), we investigated a potential mediating role of health insurance (privately insured vs. uninsured) in explaining racial and ethnic disparities in stage at diagnosis of 10 cancers (i.e., breast, prostate, colorectal, lung, cervical, uterine, bladder, head and neck, skin melanoma), detectable early through screening, physical examination, or clinical symptoms. The analyses provided evidence of mediation of non-Hispanic Black vs. White disparities in eight cancers (range of proportions mediated: 4.5%-29.1%); Hispanic vs. non-Hispanic White disparities in six cancers (13.2%- 68.8%); non-Hispanic Asian/Pacific Islander vs. White disparities in three cancers (5.8%- 11.3%). To summarize, health insurance accounts for a considerable proportion of the racial and ethnic disparities in stage III-IV diagnoses across a wide range of cancers. Citation Format: Parichoy Pal Choudhury, Helmneh M. Sineshaw, Rachel A. Freedman, Michael T. Halpern, Leticia Nogueira, Ahmedin Jemal, Farhad Islami. Contribution of health insurance to racial and ethnic disparities in advanced stage diagnosis of 10 cancers [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A082.