Most Americans under the age of 65 receive health insurance coverage through their employer, or through a parent’s employer. This means that Americans who lose their job also typically lose their health insurance. For people fighting cancer and their family members, losing health insurance coverage can be a devastating blow. In addition, Americans may miss expensive preventative screenings and treatment that may otherwise be fully covered under a typical health insurance plan, such as mammograms and the HPV vaccine.

Disruptions in access to health insurance can cause several problematic outcomes for patients diagnosed with cancer and for people who routinely miss preventative care. According to a study published in the Journal of the National Cancer Institute, uninsured persons were significantly more likely to present with an advanced stage of cancer than people with health insurance. Uninsured cancer patients were also significantly less likely to receive any or all recommended cancer treatment and experienced worse outcomes, including decreased chances of survival.

Because of the out-of-pocket cost of medical tests and treatments without insurance, uninsured people often avoid seeking treatment until cancer symptoms are severe. Advanced cancer is generally more difficult to treat than early-stage cancer, especially if it has metastasized from its location of origin. This alone could cause decreased chances of survival, but when coupled with the fact that some uninsured cancer patients avoid treatment in part or in full due to the cost, odds of survival are significantly impacted.

This situation is true for the chronically uninsured and for those who experience gaps in coverage during job losses or loss in Medicaid coverage. Understanding the potential implications of health insurance status can help doctors to best treat patients, with and without cancer.