Evidence map›Paper›PMID 37707661›Full record

ArticleJournal of racial and ethnic health disparities2024

Effect of Medicaid Expansion in Reducing Racial Disparities in Early Onset Colorectal Cancer.

Shafia Rahman, Riya Patel, Jianyou Liu, Anu Gaba, Radhashree Maitra, Ana Acuna-Villaorduna, Mimi Kim, Sanjay Goel

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Article in Journal of racial and ethnic health disparities, 2024. 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
–field-weighted citation impact
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

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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.

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4 · The record

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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

8 authors.

Shafia RahmanDepartment of Medical Oncology, Ohio State University, Columbus, OH, USA.
Riya PatelDepartment of Medical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA.
Jianyou LiuDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Anu GabaDepartment of Medical Oncology, Sanford Health, Fargo, ND, USA.
Radhashree MaitraDepartment of Medical Oncology, Albert Einstein College of Medicine, Bronx, NY, USA.
Ana Acuna-VillaordunaDepartment of Medical Oncology, Mt. Sinai School of Medicine, New York, NY, USA.
Mimi KimDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Sanjay GoelDepartment of Medical Oncology, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, 08903, New Brunswick, NJ, USA. sanjay.goel@rutgers.edu.ORCID 0000-0002-2798-7568

Funding

National Institute for Health Research Health Protection Research Unit 1R21AG058027-01
6 · The paper itself

Abstract

backgroundThe burden of early onset colorectal cancer (EOCRC) falls disproportionately on minorities and individuals in specific geographic regions. While these disparities are likely multi-factorial, access to high-quality health care plays a significant role. We sought to determine if Medicaid expansion is associated with reducing racial disparities in EOCRC detection in Hispanics and non-Hispanic Blacks (NHB), compared to non-Hispanic Whites (NHW).

methodsAnalysis of data from National Cancer Database was undertaken to compare incidence of EOCRC among those aged 40-49 between Medicaid expansion states (ES) and non-expansion states (NES) by racial/ethnic groups. Data was classified by race (NHW, NHB, or Hispanic), state of residence (ES or NES), and time (pre- or post-expansion). The primary outcome was change in incidence rate of EOCRC among racial/ethnic groups, according to whether patients resided in Medicaid expansion or non-expansion states.

resultsAmong Hispanics, the ES showed a significant increase in EOCRC incidence post expansion as compared to NES (p = 0.03). The rate of increase in annual incidence of EOCRC among Hispanics was 4.3% per year (pre-expansion) and 9.8% (post-expansion) for ES; and 6.4% (pre-expansion) and 1% (post-expansion) in NES. However, no difference was noted among NHB (p = 0.33) and NHW (p = 0.94).

conclusionsMedicaid expansion has improved detection rates of EOCRC in ES especially in Hispanic population. This is the first study to demonstrate the effect of Medicaid expansion on the incidence of EOCRC. Based on our study findings we suggest that racial and ethnic disparities should be considered in the earlier CRC screening debates.

Indexed as

Colorectal NeoplasmsHealthcare DisparitiesHispanic or LatinoMedicaidAdultAge of OnsetBlack or African AmericanFemaleHumansIncidenceMaleMiddle AgedUnited StatesWhiteEOCRCHispanicsMedicaid expansionMinorities

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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.