The first study to directly link dental insurance to cancer outcomes is the work of a team based at Wayne State University School of Medicine that includes Assistant Professor of Otorhinolaryngology – Head and Neck Surgery John Cramer, MD, FACS.
The team explored how changes in public support for dental insurance have impacted the detection of oral cancer at an early stage. They found that reductions in Medicaid dental insurance were associated with a 6.9% decrease in early-stage oral cancer detection.
“Oral cancer survival is significantly higher with early detection – 70% five-year overall survival for stage I versus 35% with stage IVA,” Dr. Cramer said.
He is the principal investigator and senior author of “Association of Changes in Medicaid Dental Benefits with Localized Diagnosis of Oral Cavity Cancer,” published in JAMA Oncology.
Dr. Cramer cares for patients at the Barbara Ann Karmanos Cancer Institute. Its primary clinical focus is surgical oncology of the head and neck.
“I treat oral cancer patients every week and often wonder about all the factors that go into early presentation for some patients and late presentation for others,” he said. .
He became interested in the potential impact of dental insurance on the early detection of oral cancer last summer, when the US Congress considered extending dental insurance to people on Medicare.
“Disparities in oral health outweigh those in other medical care. For example, 62% of seniors do not have dental insurance. Similarly, oral cancer has one of the largest survival disparities of any cancer,” Dr. Cramer said. “These results are especially relevant to Detroit because we have one of the largest racial disparities in oral cancer survival of any city in the country. As states consider supporting dental insurance in Medicaid and the Congress is considering expanding dental coverage under Medicare, an important consideration is the potential for detecting oral cancer.
The study team included WSU first-year head and neck surgery residents Lulia Kana, MD, and Daniel Quan, MD; and Jordan Grauer, MD, a WSU researcher and resident entering the same program.
The Affordable Care Act made many cancer screening exams like colonoscopies and mammograms free, with no cost to patients.
“Dental care also plays an important role in cancer screening, but many people don’t take this into account. Many people view dental insurance as an optional type of coverage, but I think this helps reinforce the idea that dental insurance is not just about clean teeth, but is important for the role of screening of cancer,” Dr. Cramer said.
The team plans a follow-up study focused on the impact of dental insurance cuts for Medicaid patients on racial disparities in oral cancer.
“We are trying to continue to investigate this relationship between dental insurance and oral cancer, and would like to advocate for policy change at the state and national level,” he said. added.
