The Association Between Medical Insurance, Access to Care, and Outcomes for Patients with Uveal Melanoma in the United States.

PURPOSE: To investigate the association between insurance status and uveal melanoma (UM) care.

METHODS

We utilized the National Cancer Database to identify patients diagnosed with UM from 2004 to 2017. We examined the associations between patient sociodemographic characteristics, specifically insurance status, and UM care.

RESULTS

Of 7677 patients, 50% had private, 41% Medicare, 4% Medicaid, 3% other government, and 3% no insurance. Most initially received brachytherapy (66%), followed by enucleation/resection (19%) and other treatment (15%). Compared to private, Medicaid and no insurance were associated with higher odds of late-stage disease presentation (p < .05). Patients with Medicare, Medicaid, and no insurance had higher odds of enucleation/resection and lower odds of brachytherapy versus enucleation/resection (p < .05 for all). Medicaid and no insurance were associated with lower odds of other treatment versus enucleation/resection (p < .05).

CONCLUSIONS

Access barriers to UM care may exist based on insurance status and may be associated with later-stage presentation and more radical treatment.