Universal health care improves colon cancer survival rates? U.S. military’s system shows it’s possible

PHILADELPHIA, Pa. — A new study finds colon cancer patients enrolled in the U.S. military’s universal health care system show greater survival rates than other colon cancer patients within the general population.

“Colorectal cancer has the third highest death rate out of all cancers in the U.S. Therefore, it is highly important to improve survival of patients with colon cancer,” says study author Craig D. Shriver, MD, FACS, FSSO, a retired U.S. Army colonel and professor and director of the Murtha Cancer Center Research Program at Uniformed Services University of the Health Sciences, in a media release.

Prior studies have already discovered that patients either without any health insurance or enrolled in Medicaid tend to experience higher colon cancer mortality rates than those with private insurance. However, few investigations have dived into the topic of how the U.S. Military Health System (MHS) influences colon cancer outcomes. The MHS provides universal health care services to both active and retired service members, National Guard members, and their families.

Universal care may improve health outcomes for minorities

Researchers analyzed data from the Department of Defense’s Automated Central Tumor Registry (ACTUR) and matched 11,907 ACTUR patients to 23,814 patients in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. This helped the team to compare survival rates between colon cancer patients in the Military Health System and those in the general population. Each patient had been diagnosed with colon cancer at some point between Jan. 1, 1987 and Dec. 31, 2013.

After an average follow-up time of 56 months for the ACTUR patients and 49 months for the SEER patients, researchers discovered ACTUR colon cancer patients showed an 18-percent lower risk of death in comparison to SEER patients. This finding held up regardless of race, gender, age, and other influential factors.

The survival benefit appears to be most prominent among Black patients. This is notable because African Americans generally have poorer colon cancer survival rates than white Americans. Compared to Black patients in the SEER database, those in the ACTUR database were 26 percent less likely to die of colon cancer.

According to Dr. Shriver, much of the larger colon cancer mortality rate among African Americans traces back to a lack of access to medical care. So, the coverage provided by the military in these scenarios had a larger positive effect on the Black study population.

“The survival benefit of Blacks in our study suggests that a universal health care system may be helpful to reduce racial disparity,” he adds.

The military’s plan helps detect cancer earlier

Study authors also compared what cancer stage a tumor was in at diagnosis. The team conducted the review to assess if universal health care coverage also helps to detect colon cancer faster. Sure enough, the study finds patients in the ACTUR database were more likely than SEER patients to receive a colon cancer diagnosis while the disease was still in the first stage (22.67% vs. 18.64%). Additionally, SEER database patients were more likely to be diagnosed with stage four colon cancer (21.63% vs. 18.74% among ACTUR patients).

“The Military Health System provides medical care with minimal or usually no financial barriers. Thus, our findings provide solid evidence of the benefits of access to universal health care,” Dr. Shriver concludes. “What’s more, when medical care is universally provided to all patients, racial disparity in colon cancer outcomes can be reduced.”

The study appears in the journal Cancer Epidemiology, Biomarkers & Prevention.

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