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States that participate in the Affordable Care Act's expansion of Medicaid have experienced an increase in overall cancer diagnoses, particularly early stage diagnoses, compared with states that rejected expansion, researchers found.
"It's been well-established that catching cancer in its early phases increases the likelihood of successful treatment and reduces the chances of death," said lead researcher Aparna Soni.
"We found that states that participated in Medicaid expansion experienced much greater increases in cancer detection," said Soni, a doctoral candidate at the Indiana University School of Business in Bloomington.
Medicaid is the publicly funded insurance program for the poor.
The study findings indicate that cancers may go undetected if people lose their health insurance due to any rollbacks of the Affordable Care Act (ACA), said Dr. Ahmedin Jemal of the American Cancer Society. He is vice president of surveillance and health services research.
The issue is timely with passage in Congress this week of a massive tax reform bill. That bill included the elimination of the individual mandate, which had forced most uninsured Americans to enter into ACA health insurance "pools" or face a penalty. However, it did not affect Medicaid expansion under Obamacare.
For the new study, Soni and her colleagues examined cancer registry data from 2010 through 2014 to estimate changes in county-level cancer diagnosis rates in states that expanded Medicaid. The data involved people aged 19 to 64 years in 13 states and included 611 counties. Nine of the states expanded Medicaid by 2014.
The researchers found that Medicaid expansion has been tied to a 6.4 percent increase in early stage cancer diagnoses, or about 15 additional cancers detected for every 100,000 people.
The increase in early stage diagnoses largely occurred in those aged 35 to 54 with cancers that are easiest to detect, such as breast and colon cancers, the findings showed.
The overall cancer diagnosis rate increased by 3.4 percent, compared against states that didn't expand Medicaid under the ACA. This was largely driven by increases in detection among people aged 45 to 54 and among those with prostate cancer, the study authors said.
"One of the key objectives of the ACA was to increase early cancer detection by improving access to care, particularly for low-income and vulnerable populations," Soni said.
"We can see from our study that people who have health insurance are able to get their cancers detected early, because they can afford to go to the doctor," she continued. "If you're uninsured, perhaps you'd put it off until it's too late."
In the long run, the ACA could produce savings for the health care system by helping people catch their cancers at an early and more treatable stage, Soni added.
"Treatment tends to be more expensive the later the cancer is caught, because later-stage cancers require more advanced and costly therapies," Soni explained.
The new study was published online Dec. 21 in the American Journal of Public Health.
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SOURCES: Aparna Soni, doctoral candidate, Indiana University Kelley School of Business, Bloomington; Ahmedin Jemal, DVM, Ph.D., vice president, surveillance and health services research, American Cancer Society; Dec. 21, 2017, American Journal of Public Health, online