ArticleJournal of the American College of Surgeons2019
Impact of the Affordable Care Act on Colorectal Cancer Screening, Incidence, and Survival in Kentucky.
Article in Journal of the American College of Surgeons, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 4 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 4 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- A systematic review of methods to estimate colorectal cancer incidence using population-based cancer registries.BMC medical research methodology · 2022Pooled it
- Evaluating Medicaid expansion benefits for patients with cancer: National Cancer Database analysis and systematic review.Journal of cancer policy · 2021Pooled it
- The Affordable Care Act's Medicaid Expansion and Impact Along the Cancer-Care Continuum: A Systematic Review.Journal of the National Cancer Institute · 2020Pooled it
- Impact of the Affordable Care Act on Colorectal Cancer Outcomes: A Systematic Review.American journal of preventive medicine · 2020Pooled it
- Changes in Medicaid Enrollment Among Adult Survivors of Childhood Cancer After Medicaid Expansion: A Report From the Childhood Cancer Survivor Study.JCO oncology practice · 2026Article
- Association of Medicaid expansion with colon cancer care: treatment patterns and survival in non-metastatic cases from state registry-claims data.Cancer causes & control : CCC · 2025Article
- Annual cases of colon cancer by age group after Medicaid expansion in the USA in 2014: a difference-in-differences study.BMJ open · 2025Article
- Review
- Implications of the initial Braidwood v. Becerra ruling for colorectal cancer outcomes: a modeling study.Journal of the National Cancer Institute · 2025Article
- Survival Disparity and the Unique Genomic and Microbiome Profiles of Colon Cancer in Appalachian Kentucky.Journal of the American College of Surgeons · 2025Article
- Article
- Pre-pandemic patterns in colorectal cancer mortality and Black-White inequities across the 30 most populous US cities.Frontiers in epidemiology · 2025Article
- Impact of Medicaid expansion under the Patient Protection and Affordable Care Act on lung cancer care in the US.Journal of thoracic disease · 2024Article
- Association between Medicaid Expansion and Cutaneous Melanoma Diagnosis and Outcomes: Does Where You Live Make a Difference?Annals of surgical oncology · 2024Article
- Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured.Cancer medicine · 2024Article
- Impact of the Implementation of the Affordability Care Act on Gastric Cancer Survival Rates.Cureus · 2024Article
- ASO Author Reflections: Exploring the Impact-Medicaid Expansion and Improved Survival in Patients with Cutaneous Melanoma.Annals of surgical oncology · 2024Article
- Association of Medicaid expansion with 2-year survival and time to treatment initiation in gastrointestinal cancer patients: A National Cancer Database study.Journal of surgical oncology · 2023Article
- Impact of Medicaid Expansion on the Treatment and Outcomes of Intrahepatic Cholangiocarcinoma.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Long-Term Impact of Medicaid Expansion on Colorectal Cancer Screening in Its Targeted Population.Digestive diseases and sciences · 2023Article
Corrections and comments
- Commented on byDiscussion.2019
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundKentucky ranks first in the US in cancer incidence and mortality. Compounded by high poverty levels and a high rate of medically uninsured, cancer rates are even worse in Appalachian Kentucky. Being one of the first states to adopt the Affordable Care Act (ACA) Medicaid expansion, insurance coverage markedly increased for Kentucky residents. The purpose of our study was to determine the impact of Medicaid expansion on colorectal cancer (CRC) screening, diagnosis, and survival in Kentucky. STUDY
designThe Kentucky Cabinet for Health and Family Services and the Kentucky Cancer Registry were queried for individuals (≥20 years old) undergoing CRC screening (per US Preventative Services Task Force) or diagnosed with primary invasive CRC from January 1, 2011 to December 31, 2016. Colorectal cancer screening rates, incidence, and survival were compared before (2011 to 2013) and after (2014 to 2016) ACA implementation.
resultsColorectal cancer screening was performed in 930,176 individuals, and 11,441 new CRCs were diagnosed from 2011 to 2016. Screening for CRC increased substantially for Medicaid patients after ACA implementation (+230%, p < 0.001), with a higher increase in screening among the Appalachian (+44%) compared with the non-Appalachian (+22%, p < 0.01) population. The incidence of CRC increased after ACA implementation in individuals with Medicaid coverage (+6.7%, p < 0.001). Additionally, the proportion of early stage CRC (stage I/II) increased by 9.3% for Appalachians (p = 0.09), while there was little change for non-Appalachians (-1.5%, p = 0.60). Colorectal cancer survival was improved after ACA implementation (hazard ratio 0.73, p < 0.01), particularly in the Appalachian population with Medicaid coverage.
conclusionsImplementation of Medicaid expansion led to a significant increase in CRC screening, CRC diagnoses, and overall survival in CRC patients with Medicaid, with an even more profound impact in the Appalachian population.
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