ArticleJournal of the National Cancer Institute2021
Association of Medicaid Expansion With Cancer Stage and Disparities in Newly Diagnosed Young Adults.
Article in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Racial disparities in time to treatment initiation and survival outcomes in patients with vulvar cancer: a national cancer database analysis.International journal of clinical oncology · 2026Observational
- Disparities in Rural-Urban Cancer Care Outcomes among Pediatric, Adolescent, and Young Adult Populations: A Comprehensive Narrative Review.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Review
- Medicaid Expansion and Place-Based Disparities in Non-Small Cell Lung Cancer Diagnosis and Survival.JAMA network open · 2026Article
- Social Risk Burden among US Cancer Survivors across Adulthood: Evidence from the 2022-2023 BRFSS.Cancer research communications · 2026Article
- Cardiomyopathy Screening Adherence Among Medicaid-Enrolled Long-Term Survivors of Childhood Cancer.Cancer medicine · 2025Article
- Association Between Medicaid Coverage Continuity and Survival in Patients With Newly Diagnosed Pediatric and Adolescent Cancers.JCO oncology practice · 2025Article
- Medicaid coverage continuity is associated with lymphoma stage among children and adolescents/young adults.Blood advances · 2025Article
- Impact of Medicaid expansion on stage of diagnosis of lung cancer for rural and urban patients in New Hampshire.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- The lasting impact of the ACA: how Medicaid expansion reduces outcome disparities in AYAs with leukemia and lymphoma.Hematology. American Society of Hematology. Education Program · 2024Article
- Association of Medicaid Expansion With Timely Receipt of Treatment and Survival Among Patients With HR-Negative, HER2-Positive Breast Cancer.Journal of the National Comprehensive Cancer Network : JNCCN · 2024Article
- Association Between State Medicaid Policies and Accrual of Black or Hispanic Patients to Cancer Clinical Trials.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Article
- Survivorship after adolescent and young adult cancer: models of care, disparities, and opportunities.Journal of the National Cancer Institute · 2024Article
- Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured.Cancer medicine · 2024Article
- Article
- Access to Care for Adolescents and Young Adults With Cancer in the United States: State of the Literature.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Review
- Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer.JNCI cancer spectrum · 2023Article
- Cost of Cancer in Adolescents and Young Adults in the United States: Results of the 2021 Report by Deloitte Access Economics, Commissioned by Teen Cancer America.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Survival in Young Adults With Cancer Is Associated With Medicaid Expansion Through the Affordable Care Act.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Did Medicaid expansion close African American-white health care disparities nationwide? A scoping review.BMC public health · 2022Article
- Rural-Urban Disparities in Cancer Outcomes: Opportunities for Future Research.Journal of the National Cancer Institute · 2022Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundYoung adults (YAs) experience higher uninsurance rates and more advanced stage at cancer diagnosis than older counterparts. We examined the association of the Affordable Care Act Medicaid expansion with insurance coverage and stage at diagnosis among YAs newly diagnosed with cancer.
methodsUsing the National Cancer Database, we identified 309 413 YAs aged 18-39 years who received a first cancer diagnosis in 2011-2016. Outcomes included percentages of YAs without health insurance at diagnosis, with stage I (early-stage) diagnoses, and with stage IV (advanced-stage) diagnoses. We conducted difference-in-difference (DD) analyses to examine outcomes before and after states implemented Medicaid expansion compared with nonexpansion states. All statistical tests were 2-sided.
resultsThe percentage of uninsured YAs decreased more in expansion than nonexpansion states (adjusted DD = -1.0 percentage points [ppt], 95% confidence interval [CI] = -1.4 to -0.7 ppt, P < .001). The overall percentage of stage I diagnoses increased (adjusted DD = 1.4 ppt, 95% CI = 0.6 to 2.2 ppt, P < .001) in expansion compared with nonexpansion states, with greater improvement among YAs in rural areas (adjusted DD = 7.2 ppt, 95% CI = 0.2 to 14.3 ppt, P = .045) than metropolitan areas (adjusted DD = 1.3 ppt, 95% CI = 0.4 to 2.2 ppt, P = .004) and among non-Hispanic Black patients (adjusted DD = 2.2 ppt, 95% CI = -0.03 to 4.4 ppt, P = .05) than non-Hispanic White patients (adjusted DD = 1.4 ppt, 95% CI = 0.4 to 2.3 ppt, P = .008). Despite the non-statistically significant change in stage IV diagnoses overall, the percentage declined more (adjusted DD = -1.2 ppt, 95% CI = -2.2 to -0.2 ppt, P = .02) among melanoma patients in expansion relative to nonexpansion states.
conclusionsWe provide the first evidence, to our knowledge, on the association of Medicaid expansion with shifts to early-stage cancer at diagnosis and a narrowing of rural-urban and Black-White disparities in YA cancer patients.
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