ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2025
Impact of Medicaid expansion on stage of diagnosis of lung cancer for rural and urban patients in New Hampshire.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Association of the Affordable Care Act With Receipt of Guideline-Concordant Adjuvant Chemotherapy for Colon and Non-Small Cell Lung Cancer.Cancer medicine · 2026Article
- Medicaid Expansion and Place-Based Disparities in Non-Small Cell Lung Cancer Diagnosis and Survival.JAMA network open · 2026Article
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Authors and funding
3 authors.
Funding
Abstract
purposeThis study examines the impact of Medicaid expansion under the Affordable Care Act on the stage of lung cancer diagnosis among rural and urban patients in New Hampshire.
methodsData from the New Hampshire State Cancer Registry spanning 2010-2019 were analyzed to compare lung cancer diagnosis stages before and after the July 2014 Medicaid expansion. Rural-urban categorization utilized Rural-Urban Continuum Codes, and logistic regression with difference-in-difference analysis assessed the differential effects of Medicaid expansion on late-stage diagnoses between rural and urban patients.
findingsPost-expansion, there was a significant decrease in the proportion of late-stage lung cancer diagnoses statewide. Rural patients initially had higher rates of late-stage diagnoses compared to urban patients, but post-expansion, this disparity diminished significantly. Logistic regression indicated reduced odds of late-stage diagnosis among rural patients after expansion (OR = 0.719, P = .035), demonstrating a greater benefit in rural areas.
conclusionsMedicaid expansion in New Hampshire was associated with a substantial reduction in late-stage lung cancer diagnoses, particularly benefiting rural patients who historically faced higher barriers to health care access. These findings underscore the potential of Medicaid expansion to mitigate rural-urban disparities in cancer care outcomes.
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