ArticleCancer reports (Hoboken, N.J.)2021
Association of Medicaid expansion and insurance status, cancer stage, treatment and mortality among patients with cervical cancer.
Article in Cancer reports (Hoboken, N.J.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 26 citations in OpenAlex.
- Affordable care act and 4-year all-cause mortality among U.S. working-age adults with or without cancer: 2000-2015.American journal of translational research · 2026Article
- Risk factors associated with overall survival in patients with cervical cancer: a prospective cohort study in Western China comparing random survival forest and Cox proportional hazards models.Journal of gynecologic oncology · 2026Article
- Medicaid expansion and overall mortality among women with cervical cancer.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Cost-Effectiveness of Pembrolizumab With Chemoradiotherapy for Locally Advanced Cervical Cancer.JAMA network open · 2025Article
- Gerotherapeutics: aging mechanism-based pharmaceutical and behavioral interventions to reduce cancer racial and ethnic disparities.Journal of the National Cancer Institute · 2025Review
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- Article
- Structural Racism in Cervical Cancer Care and Survival Outcomes: A Systematic Review of Inequities and Barriers.Current epidemiology reports · 2025Review
- The Impact of Medicaid Expansion on Stage at Diagnosis of Melanoma Patients: A Retrospective Study.Cancers · 2024Article
- Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured.Cancer medicine · 2024Article
- A health equity framework to support the next generation of cancer population simulation models.Journal of the National Cancer Institute. Monographs · 2023Article
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- Medicaid Expansion and Postoperative Mortality in Women with Gynecologic Cancer: A Difference-in-Difference Analysis.Annals of surgical oncology · 2023Article
- Medicaid expansion and 2-year survival in women with gynecologic cancer: a difference-in-difference analysis.American journal of obstetrics and gynecology · 2022Article
- Association of Medicaid expansion and insurance status, cancer stage, treatment and mortality among patients with cervical cancer.Cancer reports (Hoboken, N.J.) · 2021Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCurrently, little is known about the effect of the Patient Protection and Affordable Care Act's Medicaid expansion on care delivery and outcomes in cervical cancer.
aimWe evaluated whether Medicaid expansion was associated with changes in insurance status, stage at diagnosis, timely treatment, and survival outcomes in cervical cancer. METHODS AND
resultsUsing the National Cancer Database, we performed a difference-in-differences (DID) cross-sectional analysis to compare insurance status, stage at diagnosis, timely treatment, and survival outcomes among cervical cancer patients residing in Medicaid expansion and nonexpansion states before (2011-2013) and after (2014-2015) Medicaid expansion. January 1, 2014 was used as the timepoint for Medicaid expansion. The primary outcomes of interest were insurance status, stage at diagnosis, treatment within 30 and 90 days of diagnosis, and overall survival. Fifteen thousand two hundred sixty-five patients (median age 50) were included: 42% from Medicaid expansion and 58% from nonexpansion states. Medicaid expansion was significantly associated with increased Medicaid coverage (adjusted DID = 11.0%, 95%CI = 8.2, 13.8, p < .01) and decreased rates of uninsured (adjusted DID = -3.0%, 95%CI = -5.2, -0.8, p < .01) among patients in expansion states compared with non-expansion states. However, Medicaid expansion was not associated with any significant changes in cancer stage at diagnosis or timely treatment. There was no significant change in survival from the pre- to post-expansion period in either expansion or nonexpansion states, and no significant differences between the two (DID-HR = 0.95, 95%CI = 0.83, 1.09, p = .48).
conclusionAlthough Medicaid expansion was associated with an increase in Medicaid coverage and decrease in uninsured among patients with cervical cancer, the effects of increased coverage on diagnosis and treatment outcomes may have yet to unfold. Future studies, including longer follow-up are necessary to understand the effects of Medicaid expansion.
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