ArticleFrontiers in oncology2022
Changes in Cancer Mortality by Race and Ethnicity Following the Implementation of the Affordable Care Act in California.
Article in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Association of insurance status among cancer patients and survival outcomes: a systematic review and meta-analysis.International journal for equity in health · 2025Pooled it
- Causal decomposition framework for quantifying intervenable cancer health disparities.Biometrics · 2026Article
- Cancer disparities: an extensive review.Ecancermedicalscience · 2026Review
- 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
- A Rising Tide Raises All Ships: Was the Effect of Medicaid Expansion on Cancer Outcomes Similar Across Subgroups of Patients With Cancer on Medicaid?AJPM focus · 2025Article
- Disparities in Cancer Stage Shifts Associated with the COVID-19 Pandemic in California, 2020 to 2021.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Structural Racism in Cervical Cancer Care and Survival Outcomes: A Systematic Review of Inequities and Barriers.Current epidemiology reports · 2025Review
- Impact of the Implementation of the Affordability Care Act on Gastric Cancer Survival Rates.Cureus · 2024Article
- Comparative impact of the affordable care act on breast cancer outcomes among women in two US states.Frontiers in oncology · 2024Article
- Racial disparities in colorectal cancer outcomes and access to care: a multi-cohort analysis.Frontiers in public health · 2024Article
- Construction and validation of a nomogram for predicting overall survival of patients with stage III/IV early-onset colorectal cancer.Frontiers in oncology · 2024Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
Although Affordable Care Act (ACA) implementation has improved cancer outcomes, less is known about how much the improvement applies to different racial and ethnic populations. We examined changes in health insurance coverage and cancer-specific mortality rates by race/ethnicity pre- and post-ACA. We identified newly diagnosed breast (n = 117,738), colorectal (n = 38,334), and cervical cancer (n = 11,109) patients < 65 years in California 2007-2017. Hazard rate ratios (HRR) and 95% confidence intervals (CI) were calculated using multivariable Cox regression to estimate risk of cancer-specific death pre- (2007-2010) and post-ACA (2014-2017) and by race/ethnicity [American Indian/Alaska Natives (AIAN); Asian American; Hispanic; Native Hawaiian or Pacific Islander (NHPI); non-Hispanic Black (NHB); non-Hispanic white (NHW)]. Cancer-specific mortality from colorectal cancer was lower post-ACA among Hispanic (HRR = 0.82, 95% CI = 0.74 to 0.92), NHB (HRR = 0.69, 95% CI = 0.58 to 0.82), and NHW (HRR = 0.90; 95% CI = 0.84 to 0.97) but not Asian American (HRR = 0.95, 95% CI = 0.82 to 1.10) patients. We observed a lower risk of death from cervical cancer post-ACA among NHB women (HRR = 0.68, 95% CI = 0.47 to 0.99). No statistically significant differences in breast cancer-specific mortality were observed for any racial or ethnic group. Cancer-specific mortality decreased following ACA implementation for colorectal and cervical cancers for some racial and ethnic groups in California, suggesting Medicaid expansion is associated with reductions in health inequity.
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Registered trials
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