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Slatore CG, Au DH, Gould MK, American Thoracic Society Disparities in Healthcare Group. An official American Thoracic Society systematic review: insurance status and disparities in lung cancer practices and outcomes. American journal of respiratory and critical care medicine. 2010 Nov 1; 182(9):1195-205.
Patients with Medicaid or no insurance consistently had worse outcomes than other patients with lung cancer. Some of the disparities may be secondary to residual confounding from smoking and other health behaviors, but available data suggest that patients with lung cancer without insurance do poorly because access to care is limited and/or they present with more advanced disease that is less amenable to treatment.