Correlates of late stage breast cancer and death in a Medicaid-insured population.

The authors examine how patient and insurance characteristics influence breast cancer stage at diagnosis and survival in women insured by Medicaid (N = 1,159). Two risk factors were identified for women under 65: absence of Medicaid enrollment prior to diagnosis and residency in a nursing home. Women who were not Medicaid insured prior to diagnosis were nearly 2 times more likely to have late stage disease relative to women enrolled during the month of diagnosis, and women receiving nursing home benefits had 2.47 higher odds of late stage disease relative to women who did not receive this type of care. These two variables also influenced the likelihood of death. Additional investigation is needed to evaluate breast cancer care in nursing homes and to understand what, if any, care women receive prior to Medicaid enrollment.