Expansion of Medicaid may lead to early diagnosis of colon cancer

The expanded Medicaid of Affordable Care Acts for low-income earners appears to lead to early diagnosis of colorectal cancer, increased access to care, and improved surgical care for this common cancer patient, the study said. They are reporting in a new study. This study is published as a “press article”. Journal of American Universities of Surgeons Website before printing.

In a state that expanded Medicaid health insurance coverage in 2014, study authors reported an early-stage colonic increase. cancer Diagnose compared to states that did not implement the Medicaid extension.More Surgical patient Lead author Richard S. Hane, Fellow of Surgical Oncology at the University of Pittsburgh Medical Center (UPMC), said surgery from states with Medicade dilation is less invasive than states without dilation. He said few patients had emergency surgery. At the UPMC Hillman Cancer Center in Pittsburgh, Pennsylvania.

“There is a lack of research on how Medicaid expansion affects cancer treatment and outcomes, as our study did,” said Dr. Hane. “Our study also analyzed only data from people most likely to be affected by the expansion of Medicaid, people aged 40-64 years with Medicaid or no health insurance. It was different from other studies. “

With the expansion of Medicaid, which came into effect on January 1, 2014, the coverage of this public health insurance has been extended to lower-income people. Initially, 19 states did not implement the Medicaid expansion, but to date, all but 12 have adopted the expansion.

Access to Health care The authors write in their article that it may be particularly important for colon cancer.Colorectal and rectal cancer are the fourth most common Common cancer In the United States, it is increasing among adults under the age of 65. These adults are not covered by Medicare, the US National Health Insurance for the Elderly. Despite the availability of colonoscopy to screen for colorectal cancer, the American Cancer Society has given three Americans who should undergo this screening for reasons, including inadequate health insurance. One reports that he will not receive it.

Researchers used data on invasive colorectal cancer collected from the National Cancer Database (NCDB), the largest cancer registry of this type. The NCDB, co-sponsored by the American Academy of Surgeons and the American Cancer Society, contains information on more than 70% of newly diagnosed cancer cases in the United States.

Dr. Hoehn and his colleagues collected colon cancer data from 4,438 patients in 19 states (“expanded states”) that expanded in January 2014, and 6,017 in 19 “non-dilated” states at the time. Compared with patient data. To estimate the relative effects of expansion policies, they chose 2011-2012 to evaluate pre-expansion data and 2015-2016 for post-expansion data.

In a statistical analysis of these periods, the researchers found no significant difference between the expanded and non-expanded states of Medicaid in terms of postoperative outcomes such as length of stay, readmission rate, and death. However, patients with stage I-III colon cancer had different timeliness of care based on the category of expansion. In the non-dilated state, the number of days to treatment (mainly surgical) increased and the proportion of patients treated in less than 30 days decreased. Dr. Hoehn said no delays in care in the extended state were observed.

Other major differences between 2015 and 2016 are:

• More patients in the expanded state were treated with an integrated network cancer program accredited by the Cancer Commission of the American Surgical Society. Research evidence for other types of cancer suggests that these programs provide better overall survival.
• Patients have moved further for care in an expanded state, suggesting that patients who lived farther from the hospital can receive care for coverage, Dr. Hoehn said.
• Expanded patients with end-stage colon cancer were more likely to receive palliative care services aimed at improving quality of life.
• Of the patients who underwent cancer surgery, many in the expanded state underwent minimally invasive and non-emergency surgery. Dr. Hoehn said both changes may be due to early diagnosis in these states.

Data do not reveal why patients with dilated patients were diagnosed with stage I more often than before after dilated, but the UPMC Hillman Cancer Center’s surgical tumors may have improved access to care. Dr. Samer T. Tohme, a doctor and assistant professor, said. Surgery, University of Pittsburgh School of Medicine. He said their findings showed that the expansion of Medicaid allowed previously uninsured people to see and be screened by their primary care physicians. Colon cancer..

“Studies show that patients diagnosed with cancer early are more likely to have better treatment options, improved quality of care, and longer survival,” Dr. Tome said.

However, their study did not track survival or other long-term results.

Dr. Hoehn said it is important to study the impact of expanded health insurance coverage.

“Research like us is building an increase in work that suggests that affordable care methods and the expansion of Medicaid are improving access and treatment of health care for cancer patients,” he said. Said.