健康保险对于确保在美国获得推荐的医疗保健至关重要。本研究调查了健康保险承保中断（也称为承保流失）与接受乳腺癌和结直肠癌筛查之间的关联。符合年龄且年龄小于 65 岁（范围为 50-64 岁）的乳腺癌筛查的成年人 (n =根据 5 年的国家健康访谈调查，确定了 17,128 名女性）和结直肠癌（n = 32,562 人）癌症筛查。根据调查时的保险类型（私人、公共、无）和过去一年内承保中断情况，将成年人分为五组。筛查结果包括：(1) 曾经筛查过，(2) 过去一年的筛查，以及 (3) 符合指南的筛查。使用单独的多变量逻辑回归模型来评估保险承保中断与癌症筛查之间的关联。在调查时拥有保险的成年人中，有私人保险的 3.1% 和公共保险的 6.5% 报告之前承保中断。没有健康保险的个人的筛查水平最低。在拥有私人保险的个人中，先前的中断与调整后分析中较低的指南一致性筛查相关（乳腺癌筛查：调整后患病率 [aPR]，0.82；95% 置信区间 [CI]，0.75-0.89；结直肠癌筛查： aPR，0.78；95% CI，0.72-0.86）；在那些有公共覆盖的人中，先前的中断也与较低的指南一致性乳腺癌筛查（aPR，0.73；95% CI，0.60-0.89）和结直肠癌筛查（aPR，0.84；95% CI，0.72-0.99）相关。健康保险覆盖范围的中断与去年较低且符合指南的乳腺癌和结直肠癌筛查率相关。目前的研究结果强调了稳定的健康保险覆盖范围对于在治疗最有效时改善癌症筛查和早期发现的重要性。© 2024 美国癌症协会。

Health insurance coverage is critical for ensuring access to recommended health care in the United States. This study investigated the associations of health insurance coverage disruptions, also known as coverage churn, and receipt of breast and colorectal cancer screening.Adults who were age-eligible and younger than 65 years (range, 50-64 years) for breast (n = 17,128 women) and colorectal (n = 32,562 individuals) cancer screening were identified from 5 years of the National Health Interview Survey. Adults were categorized into five groups based on insurance type at survey (private, public, none) and prior coverage disruptions within the past year. Screening outcomes included: (1) ever-screened, (2) past-year screening, and (3) guideline-concordant screening. Separate multivariate logistic regression models were used to evaluate the associations between insurance coverage disruptions and cancer screening.Among adults who had coverage at the time of the survey, 3.1% with private insurance and 6.5% with public insurance reported prior coverage disruptions. Individuals without health insurance coverage had the lowest level of screening. Among individuals who had private coverage, prior disruptions were associated with lower guideline-concordant screening in adjusted analyses (breast cancer screening: adjusted prevalence ratio [aPR], 0.82; 95% confidence interval [CI], 0.75-0.89; colorectal cancer screening: aPR, 0.78; 95% CI, 0.72-0.86); among those who had public coverage, prior disruptions were also associated with lower guideline-concordant breast cancer screening (aPR, 0.73; 95% CI, 0.60-0.89) and colorectal cancer screening (aPR, 0.84; 95% CI, 0.72-0.99).Health insurance coverage disruptions were associated with lower past-year and guideline-concordant breast and colorectal cancer screening. The current findings underscore the importance of stable health insurance coverage to improve cancer screening and early detection when treatment is most effective.© 2024 American Cancer Society.