Table 3.
Likelihood of Receipt of Adjuvant Chemotherapy Among Patients With Stage III Colon Cancer by Insurance Status
| Factor | Privately Insured |
Without Private Insurance |
||
|---|---|---|---|---|
| OR (95% CI) | P | OR (95% CI) | P | |
| Travel distance, miles | ||||
| 0-12.49 | 1 | 1 | ||
| 12.5-49.9 | 0.93 (0.84 to 1.03) | .18 | 1.01 (0.94 to 1.09) | .77 |
| 50-249 | 0.68 (0.57 to 0.82) | < .001 | 0.97 (0.86 to 1.10) | .61 |
| ≥ 250 | 0.26 (0.18 to 0.36) | < .001 | 0.43 (0.30 to 0.61) | < .001 |
| Density level of MO | ||||
| High | 1 | 1 | ||
| Low | 1.26 (0.97 to 1.63) | .09 | 0.85 (0.73 to 0.98) | .03 |
| Age at diagnosis, years | ||||
| 18-50 | 1 | 1 | ||
| 51-64 | 0.73 (0.66 to 0.81) | < .001 | 0.77 (0.67 to 0.90) | < .001 |
| 65-70 | 0.49 (0.41 to 0.58) | < .001 | 0.65 (0.50 to 0.84) | .001 |
| 71-75 | 0.30 (0.25 to 0.37) | < .001 | 0.46 (0.36 to 0.61) | < .001 |
| 76-80 | 0.16 (0.13 to 0.20) | < .001 | 0.26 (0.20 to 0.35) | < .001 |
| Race/ethnicity | ||||
| Non-Hispanic white | 1 | 1 | ||
| Hispanic | 0.81 (0.66 to 1.00) | .04 | 0.95 (0.83 to 1.10) | .51 |
| Black | 0.77 (0.67 to 0.87) | < .001 | 0.81 (0.74 to 0.90) | < .001 |
| Other | 0.78 (0.62 to 0.97) | .02 | 1.07 (0.90 to 1.29) | .44 |
| Unknown | 1.13 (0.93 to 1.37) | .20 | 1.10 (0.96 to 1.25) | .16 |
| Sex | ||||
| Male | 1 | 1 | ||
| Female | 1.12 (1.02 to 1.24) | .03 | 1.05 (0.99 to 1.12) | .13 |
| Insurance | ||||
| Uninsured | 0.51 (0.40 to 0.66) | < .001 | ||
| Medicaid | 0.55 (0.42 to 0.70) | < .001 | ||
| Medicare (age 18-64 years) | 0.52 (0.40 to 0.68) | < .001 | ||
| Medicare with supplement | 1 | |||
| Medicare without supplement | 0.68 (0.61 to 0.75) | < .001 | ||
| Medicare Advantage | 0.88 (0.77 to 1.00) | .05 | ||
| Medicare/Medicaid | 0.47 (0.41 to 0.55) | < .001 | ||
| Diagnosis year | ||||
| 2007 | 1 | 1 | ||
| 2008 | 1.05 (0.92 to 1.20) | .44 | 1.01 (0.92 to 1.11) | .82 |
| 2009 | 0.94 (0.82 to 1.08) | .39 | 1.02 (0.93 to 1.12) | .65 |
| 2010 | 0.95 (0.83 to 1.08) | .44 | 1.03 (0.93 to 1.13) | .59 |
| Median income level | ||||
| < $30,000 | 1 | 1 | ||
| $30,000-$34,999 | 1.08 (0.91 to 1.28) | .38 | 0.96 (0.86 to 1.08) | .52 |
| $35,000-$45,999 | 1.05 (0.90 to 1.24) | .53 | 1.05 (0.94 to 1.17) | .37 |
| ≥ $46,000 | 1.14 (0.96 to 1.35) | .13 | 1.04 (0.92 to 1.16) | .55 |
| Missing | 0.94 (0.65 to 1.37) | .76 | 1.00 (0.73 to 1.38) | .98 |
| Facility type | ||||
| Community cancer program | 1.01 (0.86 to 1.17) | .95 | 0.95 (0.86 to 1.06) | .36 |
| Comprehensive community cancer program | 1 | 1 | ||
| Teaching/research center | 0.90 (0.78 to 1.03) | .13 | 0.93 (0.84 to 1.03) | .17 |
| NCI program/network | 1.53 (1.23 to 1.90) | < .001 | 1.05 (0.89 to 1.22) | .58 |
| Other | 1.18 (0.96 to 1.46) | .12 | 0.90 (0.80 to 1.01) | .08 |
| Charlson-Deyo comorbidity score | ||||
| 0 | 1 | 1 | ||
| 1 | 0.88 (0.78 to 0.99) | .04 | 0.88 (0.81 to 0.95) | < .001 |
| ≥ 2 | 0.67 (0.56 to 0.81) | < .001 | 0.58 (0.52 to 0.64) | < .001 |
| No. of positive lymph nodes | ||||
| < 4 | 1 | 1 | ||
| ≥ 4 | 1.10 (1.00 to 1.21) | .04 | 1.28 (1.19 to 1.38) | < .001 |
| Unknown | 0.61 (0.34 to 1.09) | .10 | 1.63 (0.93 to 2.85) | .08 |
| Tumor grade | ||||
| Well differentiated | 1 | 1 | ||
| Moderately differentiated | 1.12 (0.93 to 1.34) | .24 | 1.18 (1.03 to 1.34) | .01 |
| Poorly differentiated | 1.14 (0.94 to 1.39) | .19 | 1.25 (1.09 to 1.44) | .002 |
| Undifferentiated | 1.29 (0.91 to 1.82) | .15 | 1.36 (1.03 to 1.79) | .03 |
| Unknown | 0.68 (0.51 to 0.93) | .01 | 1.24 (0.96 to 1.59) | .09 |
| Surgical margin | ||||
| Negative | 1 | 1 | ||
| Positive | 0.91 (0.77 to 1.08) | .29 | 0.90 (0.80 to 1.02) | .11 |
| Unknown | 1.20 (0.79 to 1.81) | .40 | 0.81 (0.60 to 1.09) | .16 |
| Region | ||||
| Northeast | 1 | 1 | ||
| Midwest | 1.36 (1.15 to 1.61) | < .001 | 1.25 (1.12 to 1.40) | < .001 |
| South | 1.01 (0.86 to 1.19) | .89 | 1.01 (0.91 to 1.12) | .88 |
| West | 0.76 (0.63 to 0.92) | .005 | 0.74 (0.64 to 0.84) | < .001 |
Abbreviations: MO, medical oncologist; NCI, National Cancer Institute; OR, odds ratio.