The study’s authors concluded that “individuals without private insurance are not receiving optimum care in terms of cancer screening or timely diagnosis and follow-up with health care providers.” Advanced-stage diagnosis, they wrote, “leads to increased morbidity, decreased quality of life and survival and, often, increased costs.”  The study cites previous research that shows patients receiving a diagnosis of colon cancer in Stage I have a five-year survival rate of 93 percent, compared with 44 percent at Stage III and 8 percent at Stage IV.  “There’s evidence that not having insurance increases suffering,” said Dr. Otis W. Brawley, the American Cancer Society’s chief medical officer.  Not all cancer researchers believe that comprehensive screening and early detection is universally constructive. They argue that with certain cancers, like melanoma and prostate cancer, it can lead to misdiagnosis and overdiagnosis, with doctors identifying and treating tumors that may never cause serious problems. In some of those cases, surgery and drug therapies may actually shorten lives.  “Do these findings mean that patients without insurance are being diagnosed too late, or that insured patients are being excessively diagnosed?” said Dr. H. Gilbert Welch, a professor at Dartmouth who studies the usefulness of medical procedures. “And if it does mean that too many are being diagnosed late, we don’t know if it’s the problem of not being insured or a problem of cultural norms and patient education.”  Dr. Brawley said that the cancer society, the largest and wealthiest of the disease-centered philanthropies, received no more than 5 percent of its $1 billion in revenues from corporate donations, including some from medical suppliers and drug-makers that stood to profit from expanded screening. He said the group had rejected contributions from companies it considered directly connected to its research, and that he saw no conflict in the study on cancer and insurance.  The cancer society, Dr. Brawley said, has been conservative in its screening recommendations, which vary by cancer type and age. The study’s results, he said, would encourage broader screening for breast, colon and cervical cancers, where early detection has reduced death rates, but not necessarily for other cancers.  A version of this article appears in print on , on Page A10 of the New York edition with the headline: Study Links Diagnosis Of Cancer To Insurance. Order Reprints| Today's Paper|Subscribe
A nationwide study has found that the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in the late stages of the disease.