Evidence map›Paper›PMID 36629351›Full record

ArticleCancer medicine2023

Medicaid expansions and differences in guideline-adherent cervical cancer screening between American Indian and White women.

Danielle R Gartner, Jessica Y Islam, Claire E Margerison

Open access · goldAbstract read
In one paragraph

Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 17% 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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. 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

3 authors at 2 institutions in 1 country.

Danielle R GartnerDepartment of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.ORCID 0000-0002-0152-8961
Jessica Y IslamCancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Claire E MargerisonDepartment of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
Michigan State University · USUniversity of South Florida · US

Funding

Policy Change and Women's HealthR01HD095951 · NICHD · MICHIGAN STATE UNIVERSITY · PI MARGERISON, CLAIRE E · 2019 to 2023
$2.1M
NICHD NIH HHS R01 HD095951
6 · The paper itself

Abstract

backgroundAlthough preventable through screening, cervical cancer incidence and mortality are higher among American Indian and Alaska Native women (AIAN) than White women. The Patient Protection and Affordable Care Act's (ACA) Medicaid expansions may uniquely impact access and use of cervical cancer screening among AIAN women and ultimately alleviate this disparity.

methodsUsing Medicaid eligible AIAN (N = 4681) and White (N = 57,661) women aged 18-64 years from the 2010-2020 Behavioral Risk Factor Surveillance System, we implemented difference-in-differences regression to estimate the association between the Medicaid expansions and guideline-adherent cervical cancer screening and health care coverage.

resultsThe Medicaid expansions were not associated with guideline-adherent cervical cancer screening (AIAN: -1 percentage point [ppt] [95% confidence interval, CI: -4, 2 ppts]; White: 3 ppts [95% CI: -0, 6 ppts]), but were associated with a 2 ppt increase (95% CI: 0, 4 ppt) in having had a pap test in the last 5 years among White women. The Medicaid expansions were also associated with increases in having a health plan (AIAN: 5 ppts [95% CI: 1, 9]; White: 11 ppts [95% CI: 7, 15]) and decreases in avoiding medical care due to costs (AIAN: -8 ppts [95% CI: -13, -2]; White: -6 ppts [95% CI: -9, -4]).

conclusionsWhile we observed improvements in health care coverage, we did not observe changes to guideline-adherent cervical cancer screening following the ACA's Medicaid expansions. Given the disproportionate burden of cervical cancer among AIAN women, identifying ways to improve cervical cancer screening uptake and delivery should be prioritized to reduce preventable deaths.

Indexed as

American Indian or Alaska NativeUterine Cervical NeoplasmsAdolescentAdultEarly Detection of CancerFemaleHumansMedicaidMiddle AgedPatient Protection and Affordable Care ActUnited StatesWhiteYoung AdultAmerican Indians or Alaska Nativesearly detection of cancerhealthcare disparitiesMedicaidPapanicolaou test

Identifiers

PMID36629351
PMCPMC10134301
OpenAlexW4315619588

What OpenQuestion holds

Textmetadata
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.