Conclusions
Ours was the first study to examine the relationship between cervical cancer stage and insurance in a large contemporary cohort of women. We found age to be the strongest predictor of advanced-stage disease, regardless of insurance type, and uninsured and Medicaid-insured patients to be significantly more likely to present with advanced-stage cervical cancer than were women with private insurance. Advanced-stage disease leads not only to poorer quality of life and greater morbidity, but often to higher treatment costs as well. Screening should be made accessible and affordable for all women for whom it is recommended, especially for those at higher risk of advanced-stage disease, such as middle-aged women, Medicaid recipients, and uninsured women.