The impact of health insurance affiliation and socioeconomic status on cervical cancer survival in Bucaramanga, Colombia
View/ Open
Date
2023-05-05Corporate Author(s)
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística
Type
Artículo de revista
ISSN
1877-7821 / 1877-783X (Electrónico)
COAR
Artículo de revistaShare this record
Citación
Metadata
Show full item record
PDF documents
Abstract
Cervical cancer is still an important cause of death in countries like Colombia. We aimed to determine whether socioeconomic status of residential address (SES) and type of health insurance affiliation (HIA) might be associated with cervical cancer survival among women in Bucaramanga, Colombia. All patients residing in the Bucaramanga Metropolitan Area diagnosed with invasive cervical cancer (ICD-0–3 codes C53.X) between 2008 and 2016 (n = 725) were identified through the population-based cancer registry, with 700 women having follow-up data for >5 years (date of study closure: Dec 31, 2021), yielding an overall 5-year survival estimate (95 % CI) of 56.4 % (52.7 – 60.0 %). KM estimates of 5-year overall survival were obtained to assess differences in cervical cancer survival by SES and HIA. Multivariable Cox-proportional hazards modeling was also conducted, including interaction effects between SES and HIA. Five-year overall survival was lower when comparing low vs. high SES (41.9 % vs 57.9 %, p < 0.0001) and subsidized vs. contributive HIA (45.1 % vs 63.0 %, p < 0.0001). Multivariable Cox modeling showed increased hazard ratios (HR) of death for low vs. high SES (HR = 1.78; 95 % CI = 1.18–2.70) and subsidized vs. contributive HIA (HR = 1.44; 95 % CI = 1.13–1.83). The greatest disparity in HR was among women of low SES affiliated to subsidized HIA (vs. contributive HIA and high SES) (HR=2.53; 95 % CI = 1.62–3.97). Despite Colombia’s universal healthcare system, important disparities in cervical cancer survival by health insurance affiliation and socioeconomic status remain.
Spatial coverage (cities)
Bucaramanga (Colombia)Spatial coverage
ColombiaTemporary coverage
2008-2021Community
Pacientes con Cáncer de cuello uterinoLink to the resource
https://search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=edselc&AN=edselc.2-52.0-85152131099&lang=es&site=eds-live&scope=site&custid=s6670599Source
Cancer Epidemiology; Volumen 85 , Páginas 1 - 6 (2023)
Google Analytics Statistics
Collections
- Artículos [705]