Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지
DOI QR코드

DOI QR Code

Differences in the Survival of Gastric Cancer Patients after Gastrectomy according to the Medical Insurance Status

  • Jang, Jae Seong (Department of Surgery, Seoul Medical Center) ;
  • Shin, Dong Gue (Department of Surgery, Seoul Medical Center) ;
  • Cho, Hye Min (Department of Family Medicine, Seoul Medical Center) ;
  • Kwon, Yujin (Department of Surgery, Seoul Medical Center) ;
  • Cho, Dong Hui (Department of Surgery, Seoul Medical Center) ;
  • Lee, Kyung Bok (Department of Surgery, Seoul Medical Center) ;
  • Park, Sang Soo (Department of Surgery, Seoul Medical Center) ;
  • Yoon, Jin (Department of Surgery, Seoul Medical Center) ;
  • Jang, Yong Seog (Department of Surgery, Seoul Medical Center) ;
  • Kim, Il Myung (GI Cancer Center, Dongnam Inst. of Radiological & Medical Sciences)
  • Received : 2013.11.29
  • Accepted : 2013.12.17
  • Published : 2013.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: In Korea, the entire population must enroll in the national health insurance system, and those who are classified as having a lower socioeconomic status are supported by the medical aid system. The aim of this study was to evaluate the association of the medical insurance status of gastric cancer patients with their survival after gastrectomy. Materials and Methods: A total of 247 patients who underwent surgical treatment for gastric cancer between January 1999 and December 2010 at the Seoul Medical Center were evaluated. Based on their medical insurance status, the patients were classified into two groups: the national health insurance registered group (n=183), and the medical aid covered group (n=64). The survival rates were calculated using the Kaplan-Meier method. Results: The median postoperative duration of hospitalization was longer in the medical aid covered group and postoperative morbidity and mortality were higher in the medical aid group than in the national health insurance registered group (P<0.05). The overall 5-year survival rate was 43.9% in the medical aid covered group and 64.3% in the national health insurance registered group (P=0.001). Conclusions: The medical insurance status reflects the socioeconomic status of a patient and can influence the overall survival of gastric cancer patients. A more sophisticated analysis of the difference in the survival time between gastric cancer patients based on their socioeconomic status is necessary.

Keywords

References

  1. Jung KW, Won YJ, Kong HJ, Oh CM, Shin A, Lee JS. Survival of Korean adult cancer patients by stage at diagnosis, 2006-2010: national cancer registry study. Cancer Res Treat 2013;45:162-171. https://doi.org/10.4143/crt.2013.45.3.162
  2. Noh SH, Yoo CH, Kim YI, Kim CB, Min JS, Lee KS. Results after a gastrectomy of 2,603 patients with gastric cancer : analysis of survival rate and prognostic factor. J Korean Surgical Soc 1998;55:206-213.
  3. Yim J, Hwang SS, Yoo KY, Kim CY. Contribution of incomerelated inequality and healthcare utilisation to survival in cancers of the lung, liver, stomach and colon. J Epidemiol Community Health 2012;66:37-40. https://doi.org/10.1136/jech.2009.104554
  4. Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan 2009;24:63-71.
  5. Wedding U, Röhrig B, Klippstein A, Pientka L, Höffken K. Age, severe comorbidity and functional impairment independently contribute to poor survival in cancer patients. J Cancer Res Clin Oncol 2007;133:945-950. https://doi.org/10.1007/s00432-007-0233-x
  6. Ahn HS, Lee HJ, Hahn S, Kim WH, Lee KU, Sano T, et al. Evaluation of the seventh American Joint Committee on Cancer/ International Union Against Cancer Classification of gastric adenocarcinoma in comparison with the sixth classification. Cancer 2010;116:5592-5598. https://doi.org/10.1002/cncr.25550
  7. Park JI, Jin SH, Bang HY, Paik NS, Moon NM, Lee JI. Survival rates after operation for gastric cancer: fifteen-year experience at a Korea Cancer Center Hospital. J Korean Gastric Cancer Assoc 2008;8:9-19. https://doi.org/10.5230/jkgca.2008.8.1.9
  8. Kim JG, Ryoo BY, Park YH, Kim BS, Kim TY, Im YH, et al. Prognostic factors for survival of patients with advanced gastric cancer treated with cisplatin-based chemotherapy. Cancer Chemother Pharmacol 2008;61:301-307.
  9. Kadowaki S, Komori A, Narita Y, Nitta S, Yamaguchi K, Kondo C, et al. Long-term outcomes and prognostic factors of patients with advanced gastric cancer treated with S-1 plus cisplatin combination chemotherapy as a first-line treatment. Int J Clin Oncol 2013 [Epub ahead of print].
  10. Tocchi A, Costa G, Lepre L, Liotta G, Mazzoni G, Cianetti A, et al. The role of serum and gastric juice levels of carcinoembryonic antigen, CA19.9 and CA72.4 in patients with gastric cancer. J Cancer Res Clin Oncol 1998;124:450-455. https://doi.org/10.1007/s004320050198
  11. Jiexian J, Xiaoqin X, Lili D, Baoguo T, Ting S, Xianwen Z, et al. Clinical assessment and prognostic evaluation of tumor markers in patients with gastric cancer. Int J Biol Markers 2013;28:192-200. https://doi.org/10.5301/jbm.5000023
  12. Kogevinas M, Porta M. Socioeconomic differences in cancer survival: a review of the evidence. IARC Sci Publ 1997;(138):177-206.
  13. Vona-Davis L, Rose DP. The influence of socioeconomic disparities on breast cancer tumor biology and prognosis: a review. J Womens Health (Larchmt) 2009;18:883-893. https://doi.org/10.1089/jwh.2008.1127
  14. Azzopardi J, Walsh D, Chong C, Taylor C. Surgical treatment for women with breast cancer in relation to socioeconomic and insurance status. Breast J 2013 [Epub ahead of print].
  15. Schreiber D, Chen SC, Rineer J, Weiss J, Rotman M, Schwartz D. Racial and socioeconomic disparities in the selection of prostate brachytherapy. J Contemp Brachytherapy 2013;5:139-143.
  16. Nitzkorski JR, Willis AI, Nick D, Zhu F, Farma JM, Sigurdson ER. Association of race and socioeconomic status and outcomes of patients with rectal cancer. Ann Surg Oncol 2013;20:1142-1147. https://doi.org/10.1245/s10434-012-2837-x
  17. Siemerink EJ, Hospers GA, Mulder NH, Siesling S, van der Aa MA. Disparities in survival of stomach cancer among different socioeconomic groups in North-East Netherlands. Cancer Epidemiol 2011;35:413-416. https://doi.org/10.1016/j.canep.2011.02.015
  18. Lowrie EG, Lew NL. Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis 1990;15:458-482. https://doi.org/10.1016/S0272-6386(12)70364-5
  19. Seo KW, Yoon KY. Nutritional assessment and perioperative nutritional support in gastric cancer patients. Korean J Gastroenterol 2013;61:186-190. https://doi.org/10.4166/kjg.2013.61.4.186
  20. Shim H, Cheong JH, Lee KY, Lee H, Lee JG, Noh SH. Perioperative nutritional status changes in gastrointestinal cancer patients. Yonsei Med J 2013;54:1370-1376. https://doi.org/10.3349/ymj.2013.54.6.1370
  21. Nitenberg G, Raynard B. Nutritional support of the cancer patient: issues and dilemmas. Crit Rev Oncol Hematol 2000;34:137-168. https://doi.org/10.1016/S1040-8428(00)00048-2
  22. Ottery FD. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 1996;12:S15-S19. https://doi.org/10.1016/0899-9007(95)00067-4
  23. Baker A, Wooten LA, Malloy M. Nutritional considerations after gastrectomy and esophagectomy for malignancy. Curr Treat Options Oncol 2011;12:85-95. https://doi.org/10.1007/s11864-010-0134-0
  24. Kwon YM, Lim HT, Lee K, Cho BL, Park MS, Son KY, et al. Factors associated with use of gastric cancer screening services in Korea. World J Gastroenterol 2009;15:3653-3659. https://doi.org/10.3748/wjg.15.3653
  25. Lee K, Lim HT, Hwang SS, Chae DW, Park SM. Socio-economic disparities in behavioural risk factors for cancer and use of cancer screening services in Korean adults aged 30 years and older: the Third Korean National Health and Nutrition Examination Survey, 2005 (KNHANES III). Public Health 2010;124:698-704. https://doi.org/10.1016/j.puhe.2010.07.004
  26. Seo JH, Kim N, Lee DH, Kim JW, Hwang JH, Park YS, et al. Clinical features and recent treatment trend of gastric cancer. Korean J Med 2006;71:149-157.

Cited by

  1. Impact of marital status on survival of gastric adenocarcinoma patients: Results from the Surveillance Epidemiology and End Results (SEER) Database vol.6, pp.None, 2013, https://doi.org/10.1038/srep21098
  2. Association between Socioeconomic Status and Cancer Screening in Koreans over 40 Years in Age Based on the 2010–2012 Korean National Health and Nutrition Examination Survey vol.37, pp.5, 2013, https://doi.org/10.4082/kjfm.2016.37.5.287
  3. Factors Associated With Longer Postoperative Outpatient Follow-up Duration in Patients With Single Lumbar Disc Herniation: A Noncomplicated Patient Cohort Study vol.15, pp.3, 2013, https://doi.org/10.14245/ns.1836006.003
  4. Hepatocellular carcinoma in old age: are there any benefits of liver resection in old age? vol.99, pp.2, 2013, https://doi.org/10.4174/astr.2020.99.2.65
  5. Disparities in Hepatocellular Carcinoma Survival by Insurance Status: A Population-Based Study in China vol.9, pp.None, 2013, https://doi.org/10.3389/fpubh.2021.742355