ArticleAmerican journal of preventive medicine2020
The Affordable Care Act and Ethnic Disparities in Colorectal Cancer Screening.
Article in American journal of preventive medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Impact of Eliminating Cost-Sharing by Medicare Beneficiaries for Follow-Up Colonoscopy After a Positive Stool-based Colorectal Cancer Screening Test.Cancer research communications · 2023Article
- Tools to Measure the Impact of Structural Racism and Discrimination on Gastrointestinal and Hepatology Disease Outcomes: A Scoping Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Early-Onset Colorectal Cancer: Current Insights.Cancers · 2023Review
- Health Economics Research in Cancer Screening: Research Opportunities, Challenges, and Future Directions.Journal of the National Cancer Institute. Monographs · 2022Review
- Medicaid Expansions: Probing Medicaid's Filling of the Cancer Genetic Testing and Screening Space.Healthcare (Basel, Switzerland) · 2022Review
- Article
- Cancer genetic testing in marginalized groups during an era of evolving healthcare reform.Journal of cancer policy · 2021Review
- Work in Progress: Immigrant Health Care from the Vantage of Cancer Testing and Screening.Journal of immigrant and minority health · 2021Article
- Funding of Hispanic/Latino Health-Related Research by the National Institutes of Health: An Analysis of the Portfolio of Research Program Grants on Six Health Topic Areas.Frontiers in public health · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
introductionCost sharing can deter the use of health services and act as a potential contributor to racial/ethnic disparities in cancer. The Affordable Care Act required most health plans to cover, without cost sharing, preventive services, including colorectal cancer screening. Population-based data were used to estimate the impact of the Affordable Care Act's cost-sharing provision (together with other Affordable Care Act provisions targeting preventive care) on ethnic disparities in colorectal cancer screening, comparing Hispanics with non-Hispanics.
methodsAn interrupted time series quasi-experimental analysis was used to examine ethnic differences in colorectal cancer screening pre- and post-implementation of the Affordable Care Act (analysis performed in 2018). The study cohort included insured individuals aged 50-64 years who participated in the Medical Expenditure Panel Survey from 2007 through 2015 (n=44,343).
resultsDuring the pre-Affordable Care Act period, screening rates decreased annually for non-Hispanics by -0.38 per 100 adults per year (95% CI= -0.55, -0.22) but remained level for Hispanics (annual trend per 100 adults: 0.01, 95% CI= -0.34, 0.35). After cost sharing was eliminated in 2011, colorectal cancer screening rates increased for both Hispanics (by 1.29 per 100 adults, 95% CI=0.69, 1.89) and non-Hispanics (by 0.58 per 100 adults, 95% CI=0.18, 0.99). The difference in trend increases between Hispanics and non-Hispanics was not statistically significant (0.70%, 95% CI= -0.24, 1.64).
conclusionsThese findings suggest that Affordable Care Act implementation resulted in increased colorectal cancer screening; however, the effect of the law was not significantly different between Hispanics and non-Hispanics. These results provide indications that more needs to be done to reduce racial/ethnic disparities in colorectal cancer screening.
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