Affordable Care Act Increased Rate of Early Cancer Diagnoses

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The US Affordable Care Act may have increased the proportion of patients with cancer diagnosed at stage I, according to a study.
The US Affordable Care Act may have increased the proportion of patients with cancer diagnosed at stage I, according to a study.
The following article features coverage from the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois. Click here to read more of Cancer Therapy Advisor's conference coverage.

The implementation of the Affordable Care Act (ACA) in 2014 and subsequent Medicaid expansion correlate with earlier diagnosis of breast, colorectal, and lung cancer, according to a study being presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.1

Without adequate insurance, patients with cancer in the United States are at a high risk of a late-stage diagnosis. The ACA, which was implemented in 2014, increased coverage for individuals aged 18 to 64, particularly with the advent of Medicaid expansion in particular states.

For this study, researchers evaluated diagnosis data from the National Cancer Database to determine whether the ACA — and the resulting improvements of health insurance coverage — had an effect on stage of diagnosis among patients with cancer.

The percentages of patients diagnosed with stage I disease pre– and post–ACA implementation were compared. The included cancer types were colorectal (39,418 patients), female breast (121,402 patients), cervical (11,190 patients), lung (41,436 patients), and prostate (59,210 patients).

According to Xuesong Han, PhD, of the American Cancer Society in Atlanta, Georgia, who presented this study during an ASCO briefing, the researchers controlled for age, gender, and ethnicity when determining the proportion of patients diagnosed with stage I disease.2

The proportion of patients with breast, colorectal, lung, or cervical cancer diagnosed at stage I increased by about 1 percentage point each; this was statistically significant only among patients with breast, colorectal, or lung cancer.

Patients with prostate cancer were less likely to be diagnosed with stage I disease after ACA implementation, though Dr Han noted that US Preventive Services Task Force recommendations against prostate cancer screening may explain this discrepancy.

The researchers noted that the increased number of stage I diagnoses among patients with colorectal or lung cancer were seen primarily in US states with Medicaid expansion. Stage I diagnoses among patients with breast cancer were observed “regardless of Medicaid expansion status.”

RELATED: The Affordable Care Act: Mammography and Socioeconomic Disparity

Read more of Cancer Therapy Advisor's coverage of the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting by visiting the conference page.

References

  1. Han X, Lin CC, Jemal A. Changes in stage at diagnosis of screenable cancers after the Affordable Care Act. J Clin Oncol. 2017;34(suppl; abstr 6521).
  2. 2017 ASCO annual meeting presscast. American Society of Clinical Oncology; May 17, 2017.

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