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Gynecological Cancers in the Elderly Poor
Associating outcomes with Medicare/Medicaid status
Women aged ≥65 years who were dually enrolled in Medicare and Medicaid were found to have an overall 34% increase in all-cause mortality after diagnosis with a gynecologic cancer compared with the non-dually enrolled Medicare population, according to a study of 4,522 women aged ≥ 65 years, including 3,702 enrolled in Medicare and 820 dually enrolled. Researchers found:
• Gynecologic cancers included 51% uterine, 35% ovarian, 7% cervical, and 8% vulvar/vaginal.
• Dual enrollees had increased all-causes mortality overall [adjusted hazard ratio (aHR), 1.34], and within each cancer site:
◊ Ovarian (aHR, 1.25)
◊ Cervical (aHR, 1.34)
◊ Vulvar/vaginal (aHR, 1.93)
•Increased offs of advanced-stage disease at diagnosis among dual enrollees was present only in patients with uterine cancer (adjusted odds ratio, 1.38).
• Stratified survival curves demonstrated strongest disparities among women with early-stage uterine and early-stage vulvar/vaginal cancers.
Citation: Doll KM, Meng K, Basch EM, Gehrig PA, Brewster WR, Meyer AM. Gynecologic cancer outcomes in the elderly poor: a population-based study. [Published online ahead of print July 31, 2015]. Cancer. doi: 10.1002/cncr.29541.