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TOPLINE:
A dramatic increase in cancer diagnoses following Medicaid expansion in Ohio suggests that expanding the program improves access to cancer care.
METHODOLOGY:
To assess the impact of Medicaid expansion on cancer diagnosis, investigators compared the volume of patients with newly diagnosed cancer in Ohio, which expanded its Medicaid coverage in 2014, with that of Georgia, which did not.
State cancer registries were queried from 2010 to 2017 to identify adults younger than 64 years with incident female breast cancer, cervical cancer, zoloft used for social anxiety or colorectal cancer (CRC).
TAKEAWAY:
In Ohio, researchers found a substantial increase in diagnoses for all three cancers among Medicaid patients after expansion. The increase ranged from 42% for breast cancer to 77% for CRC.
In Georgia, fewer Medicaid patients were diagnosed with breast cancer in the post-expansion period. There were also smaller increases in the number of patients diagnosed with cervical cancer (6%) and CRC (13%) compared with the post-expansion increases seen in Ohio.
The risk of being diagnosed with late-stage breast cancer fell 7% among Medicaid patients in Ohio after expansion.
The risk of being diagnosed with late-stage CRC fell 6% among Medicaid patients in George and Ohio. The Georgia results are potentially attributable to increases in state and local screening programs, especially in rural areas.
IN PRACTICE:
“These starkly different patterns in changes in the number of diagnosed [breast cancer], [cervical cancer], and CRC cases among patients on Medicaid in Ohio versus Georgia in the post-expansion period suggest that expanding insurance coverage might have effectively improved access to care,” the authors wrote.
SOURCE:
The study, led by Kirsten Eom, PhD, of the MetroHealth Population Health Research Institute, Cleveland, was published online July 25 in Cancer .
LIMITATIONS:
Medicaid status was determined at diagnosis; past studies have associated being enrolled in Medicaid at the time of cancer diagnosis, rather than before, with late‐stage disease.
The team could not assess the effectiveness of state and local cancer screening programs in preventing late-stage cancer.
DISCLOSURES:
The study was funded by the Ohio Department of Health and the Georgia Department of Public Health.
One researcher reported a grant from Celgene.
M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who worked for several major news outlets before joining Medscape. Alex is also an MIT Knight Science Journalism fellow. Email: [email protected].
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