Evidence map›Paper›PMID 35641206›Full record

ArticleThe oncologist2022

Improved Survival of Young Adults with Cancer Following the Passage of the Affordable Care Act.

Michael Roth, Amy Berkman, Clark R Andersen, Branko Cuglievan, J Andrew Livingston, Michelle Hildebrandt, Archie Bleyer

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The oncologist, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
6.5field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
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  10. 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 · 2024
    Review
  11. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Michael RothDivision of Pediatrics and Patient Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Amy BerkmanDepartment of Pediatrics, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0003-0650-3664
Clark R AndersenDivision of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Branko CuglievanDivision of Pediatrics and Patient Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J Andrew LivingstonDivision of Pediatrics and Patient Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Michelle HildebrandtDepartment of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Archie BleyerDepartment of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.ORCID 0000-0001-7738-5146
The University of Texas MD Anderson Cancer Center · USDuke University · USOregon Health & Science University · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

backgroundCompared with their ensured counterparts, uninsured adolescents and young adults (AYAs) with cancer are more likely to present with advanced disease and have poor prognoses. The Patient Protection and Affordable Care Act (ACA), enacted in 2010, provided health care coverage to millions of uninsured young adults by allowing them to remain on their parents' insurance until age 26 years (the Dependent Care Expansion, DCE). The impact of the expansion of insurance coverage on survival outcomes for young adults with cancer has not been assessed.

participantsUtilizing the Surveillance, Epidemiology, and End Results database, we identified all patients aged 12-16 (younger-AYAs), 19-23 (middle-AYAs), and 26-30 (older-AYAs) who were diagnosed with cancer between 2006-2008 (pre-ACA) and 2011-2013 (post-ACA).

methodsIn this population-based cohort study, we used an accelerated failure time model to assess changes in survival rates before and after the enactment of the ACA DCE.

resultsMiddle-AYAs ages 19-23 (thus eligible to remain on their parents' insurance) experienced significantly increased 2-year survival after the enactment of the ACA DCE (survival time ratio 1.25, 95% confidence interval: 0.75-2.43, P = .029) and that did not occur in younger-AYAs (ages 12-16). Patients with sarcoma and acute myeloid leukemia accounted for the majority of improvement in survival. Middle-AYAs of hispanic ethnicity and those with low socioeconomic status experienced trends of improved survival after the ACA DCE was enacted.

conclusionSurvival outcomes improved for young adults with cancer following the expansion of health insurance coverage. Efforts are needed to expand coverage for the millions of young adults who do not have health insurance.

Indexed as

NeoplasmsPatient Protection and Affordable Care ActAdolescentCohort StudiesHumansInsurance CoverageInsurance, HealthUnited StatesYoung AdultAffordable Care Actcancerhealth insuranceyoung adult

Identifiers

PMID35641206
PMCPMC8895735
OpenAlexW4206192096

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.