{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T01:57:02Z","timestamp":1777427822257,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2021,9,4]],"date-time":"2021-09-04T00:00:00Z","timestamp":1630713600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2022,7]]},"abstract":"\n Objective:<\/jats:title>\n To analyze insurance status effect on overall survival (OS) and disease-specific survival (DSS) in laryngeal cancer.<\/jats:p>\n <\/jats:sec>\n \n Study Design:<\/jats:title>\n Cross-sectional population analysis.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Surveillance, Epidemiology, and End Results (SEER) database.<\/jats:p>\n <\/jats:sec>\n \n Participants:<\/jats:title>\n Laryngeal cancer patients from 2007 to 2016.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures:<\/jats:title>\n Kaplan-Meier method with log-rank statistic analyzed OS and DSS by insurance status. Multivariable cox proportional hazard modeling generated survival prognostic factors.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Of 19\u2009667 laryngeal cancer cases, initial disease presentation was stage I: 7770 patients (39.5%), stage II: 3337 patients (17.0%), stage III: 3289 patients (16.7%), and stage IV: 5226 patients (26.6%). Patients had non-Medicaid insurance (15\u2009523, 78.9%), had Medicaid (3306, 16.8%), or were uninsured (891, 4.5%). Mean and median OS for insured, Medicaid, and uninsured patients were 60.5, 49.6, and 56.6 and 74.0, 40.0, and 65.0\u2009months, respectively. Following multivariable analysis, OS for insured, Medicaid, and uninsured patients was stage I: 87.9, 82.8, and 88.4 ( P\u2009<\u2009.001), stage II: 79.1, 75.1, and 78.3 ( P\u2009=\u2009.12), stage III: 68.7, 66.1, and 72.1 ( P\u2009=\u2009.11), and stage IV: 57.1, 51.7, and 50.3 ( P\u2009<\u2009.001) months. DSS mean survival times were 77.0, 65.8, and 67.7\u2009months ( P\u2009<\u2009.001) for insured, Medicaid, and uninsured patients. Age (HR: 1.02\/year, P\u2009<\u2009.001) and black (HR: 1.15, P\u2009=\u2009.001) compared to white race predicted worse survival. Compared to insured status, Medicaid insurance carried a death hazard ratio of 1.40 ( P\u2009<\u2009.001) and uninsured status had a death hazard ratio of 1.40 ( P\u2009<\u2009.001).<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Insured laryngeal cancer patients had prolonged OS and DSS compared to Medicaid and uninsured patients. Medicaid patients had equivalent survival outcomes to uninsured patients.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n 2c.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00034894211044231","type":"journal-article","created":{"date-parts":[[2021,9,4]],"date-time":"2021-09-04T05:02:25Z","timestamp":1630731745000},"page":"775-781","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Insurance Status Effect on Laryngeal Cancer Survival: A Population Based Study"],"prefix":"10.1177","volume":"131","author":[{"given":"Nicholas B.","family":"Abt","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5458-0544","authenticated-orcid":false,"given":"Lauren E.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuraag","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Bhattacharyya","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,9,4]]},"reference":[{"key":"bibr1-00034894211044231","unstructured":"American Cancer Society. Key statistics for laryngeal and hypopharyngeal cancers. Publication year: 2019. Accessed July 29, 2019. https:\/\/www.cancer.org\/cancer\/laryngeal-and-hypopharyngeal-cancer\/about\/key-statistics.html."},{"key":"bibr2-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq495"},{"key":"bibr3-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.06.015"},{"key":"bibr4-00034894211044231","doi-asserted-by":"crossref","unstructured":"Cohen J, Stock M, Chan B, et al. Microvascular reconstruction and tracheotomy are significant determinants of resource utilization in head and neck surgery. Arch Otolaryngol Head Neck Surg. 2000;126(8):947-949. Accessed July 29, 2019. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10922225.","DOI":"10.1001\/archotol.126.8.947"},{"key":"bibr5-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.171"},{"key":"bibr6-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24585"},{"key":"bibr7-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27247"},{"key":"bibr8-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.1525"},{"key":"bibr9-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816639248"},{"key":"bibr10-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24862"},{"key":"bibr11-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30398-7"},{"key":"bibr12-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30212"},{"key":"bibr13-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31095"},{"key":"bibr14-00034894211044231","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.2986"}],"container-title":["Annals of Otology, Rhinology & Laryngology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00034894211044231","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00034894211044231","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00034894211044231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:34:50Z","timestamp":1777376090000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/00034894211044231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,4]]},"references-count":14,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1177\/00034894211044231"],"URL":"https:\/\/doi.org\/10.1177\/00034894211044231","relation":{},"ISSN":["0003-4894","1943-572X"],"issn-type":[{"value":"0003-4894","type":"print"},{"value":"1943-572X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,4]]}}}