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"This is the first study to show the benefit of Medicaid expansion on cancer death rates on a national scale," said lead author Dr. Anna Lee, a radiation oncology fellow at Memorial Sloan Kettering Cancer Center in New York City.
"We now have evidence that Medicaid expansion has saved the lives of many people with cancer across the United States," she added.
Medicaid expansion is part of the Affordable Care Act enacted in 2010. At the time of the analysis, 27 states and the District of Columbia had adopted Medicaid expansion, while 23 states did not.
In the study, Lee's team analyzed nationwide data from 1999 to 2017 and found a 29% decline in cancer deaths in states that expanded Medicaid, from 65.1 to 46.3 per 100,000 people.
In states that didn't expand Medicaid, there was a 25% decline, from 69.5 to 52.3 per 100,000 people.
The additional benefits for states that expanded Medicaid amounted to an estimated 785 fewer cancer deaths in 2017 alone. The findings will be presented this week at a virtual meeting of the American Society of Clinical Oncologists (ASCO). Such research is considered preliminary until published in a peer-reviewed journal.
"This study provides needed data to understand the effects of Medicaid expansion on cancer care. Better access to quality cancer care, in this case through state expansion of Medicaid, leads to fewer cancer deaths," Dr. Richard Schilsky, ASCO chief medical officer and executive vice president, said in a meeting news release.
The study authors also examined changes in cancer death rates among specific groups, including blacks and Hispanics.
While there were significant declines in cancer deaths among blacks nationwide, no additional declines were seen in states that expanded Medicaid. However, cancer death rates were consistently worse for blacks in states without expansion than in states with expansion, 63.4 vs. 58.5 per 100,000, respectively.
In contrast, the researchers found that the greatest change in cancer death rates between expansion and non-expansion states was seen for Hispanics.
"There is a greater Hispanic population in states that have adopted Medicaid expansion, and they have almost three times the un-insurance rate as white adults," said senior study author Dr. Fumiko Chino, a radiation oncologist at Memorial Sloan Kettering.
"Our research shows that Hispanic patients with cancer may have benefited the most because they had the most to gain," she explained in the release.
-- Robert Preidt
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