ST. LOUIS - The rate of uninsured patients with head and neck cancers was "significantly reduced" following the implementation of the federal Patient Protection and Affordable Care Act (ACA).

The percentage of patients with head and neck cancer without insurance dropped from 7.7% in the pre-ACA period to 4.9% in the post-ACA period.

The findings, led by Nosayaba Osazuwa-Peters, BDS, Ph.D., MPH, of Saint Louis University's Department of Otolaryngology, were published online Oct. 31 in the latest issue of the journal JAMA Otolaryngology.

In the U.S., approximately 64,000 people are diagnosed with head and neck cancer each year and more than 14,000 die of disease-specific causes. Insurance status, Osazuwa-Peters said, is a major factor in the outcome for head and neck cancer patients.

"Treating head and neck cancer is generally complicated. You can tell that just thinking about the complex anatomic structures in the head and neck region impacted by cancer," Osazuwa-Peters said. "Besides this and other very important clinical factors associated with treatment, this study built on our previous studies, as well as other studies, that have shown that patients without health insurance are more likely to present with more advanced-stage disease. The problem is, the more advanced the disease, the more complicated the treatment is, and typically, the worse the prognosis.

"One of the benefits the ACA was supposed to provide is to reduce the disparity associated with access to care, which has been a historical problem in head and neck cancer care. Historically, cancer patients, including head and neck patients, did not all receive the same quality of care based on their insurance status, race/ethnicity, sex, or other factors that have nothing to do with their disease. This inequality was one of the issues the ACA was supposed to ameliorate."

The researchers found there was a significant difference in the changes in the percentage of uninsured patients by age, with the largest reduction of uninsured patients coming among the 18 to 34-year-old age range and the smallest in the oldest population, those aged 65-74.

Women were also more likely to be insured than men following the passage of the ACA.

The ACA has expanded insurance coverage in the United States, increasing the access to care for millions of people. Osazuwa-Peters said their research found a significantly greater reduction in the percentage of uninsured patients - 3.5% - in low-income zip codes after ACA implementation than in high-income zip codes.

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