Abstract
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Background: This study investigated trends in management of stage III NSCLC in patients with no insurance versus other insurance types using the National Cancer Database (NCDB). Methods: 281,277 patients with Stage III NSCLC were identified from 2000 to 2009 using the NCDB. Reported use of surgery, radiation, chemotherapy, or no treatment were analyzed by insurance status. Results: Radiation/chemotherapy was most often used to treat stage III NSCLC among non-insured (41.7%), Medicare (31.3%), Medicaid (42.3%), and private insured patients (43.9%). Non-insured were just as likely to receive radiation/chemotherapy as Medicaid (41.7% vs. 42.3%, p=0.36) but less likely than privately insured (41.7% vs. 43.9%, p<0.001). Non-insured were more likely to receive no treatment than privately insured (20.8% vs. 11.7%, p<0.001) and Medicaid (20.8% vs. 16.8%, p <0.001) but less likely than Medicare (20. 8% vs. 24.6%, p<0.001). Tri-modality treatment was given less often to non-insured patients than privately insured (4.6% vs. 10.2%, p<0.001) and Medicaid (4.6% vs. 6.2%, p<0.001) but more often than Medicare patients (4.6% vs. 3.7%, p<0.001). Conclusions: Stage III NSCLC was most often given chemotherapy/radiation regardless of insurance status. Non-insured patients received this treatment as often as Medicaid but less often than privately insured. Non-insured patients also received no treatment more often than Medicaid and privately insured and less often than Medicare. Future studies could examine if average age among the populations impacted these findings. [Table: see text]