Study Suggests Stable Insurance Coverage Facilitates Early Cancer Detection and Diagnosis

By Ellie Pourbohloul

Lymphoma is the third leading cause of cancer among children and adolescents/young adults (AYAs) in the United States, accounting for 10% of all pediatric cancers and 23% of adolescents’ cancers. Continuous health insurance coverage is crucial for facilitating early cancer detection and diagnosis, but many eligible young patients are not enrolled in Medicaid until or shortly after they are diagnosed with cancer. This means that their cancer may not be caught until it’s more severe at a later stage, and with potentially worse outcomes.

A recent paper published in Blood Advances by Elyse Xinyue Zhang, PhD student in health policy and management at Emory University's Rollins School of Public Health, examined whether the timing of gaining Medicaid enrollment and coverage continuity is associated with disease stage in Medicaid-insured children and AYAs diagnosed with lymphoma.

What They Found

Novel findings from this research include:

• Among children and AYAs diagnosed with lymphoma and insured by Medicaid, those who maintained continuous Medicaid coverage before diagnosis were significantly less likely to have late-stage diseases compared with those with newly gained Medicaid or with other Medicaid enrollment patterns.
• Only 3 in 8 (37.8%) Medicaid-insured children and AYAs had continuous Medicaid coverage before and during the initial lymphoma diagnosis.
• Children and AYAs with newly gained Medicaid or other Medicaid enrollment patterns faced an 18% to 54% higher likelihood of presenting with stage IV lymphoma diagnosis compared with continuous Medicaid enrollees.

Additionally, AYA patients were more likely to have newly gained Medicaid at or after lymphoma diagnosis and less likely to have continuous Medicaid coverage relative to younger pediatric patients.

Why it Matters

“Our findings underscore the importance of maintaining continuous insurance coverage, particularly as millions of children and AYAs have recently lost Medicaid coverage following the unwinding of COVID-19-related protections,” says Zhang. “They suggest that stable coverage enables earlier detection through routine care, which can lead to more timely diagnoses and better outcomes. There is an urgent need for state- and community-level strategies to support insurance continuity and reduce disparities in cancer outcomes.”