title: Breast cancer detection and outcomes in a disability beneficiary population.
abstract: Women with disabilities may be at higher risk of late-stage breast cancer. Using the 1991-93 Medicare-Surveillance Epidemiology and End Results (SEER)-linked data set, the authors compared stage at diagnosis and mortality, for Social Security Disability Insurance (SSDI)-qualifying women and similarly aged non-SSDI qualifying women. Disabled patients were diagnosed at a later American Joint Committee on Cancer stage. Disabled patients had higher all-cause mortality rates but had similar breast cancer-specific mortality. Disabled women belonging to Medicare HMOs tended to have earlier stage diagnosis and better survival compared to Medicare fee-for-service (FFS) insurance. In conclusion, disabled patients tended to be diagnosed with breast cancer at a later stage and to have higher mortality. These findings were more pronounced in Medicare FFS than in Medicare HMOs.
authors.affiliation: University of South Florida, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Roetzheim
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Chirikos
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000523:psychology / Q000628:therapy; D016022:Case-Control Studies; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data*; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D006278:Medicare / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012042:Registries; D018426:SEER Program; D016019:Survival Analysis; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014930:Women / Q000523:psychology; D016387:Women's Health