Evidence map›Paper›PMID 40347451›Full record

ArticleCancer2025

A difference-in-differences analysis of Medicaid expansion and state paid sick leave laws on colorectal cancer screening.

Jim P Stimpson, Joshua M Liao, Anna M Morenz, Joseph H Joo, Fernando A Wilson

Abstract read
In one paragraph

Article in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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

3 citing papers in PubMed.

  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

5 authors.

Jim P StimpsonDepartment of Health Economics, Systems, and Policy, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID https://orcid.org/0000-0002-1266-9436
Joshua M LiaoDepartment of Health Economics, Systems, and Policy, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Anna M MorenzDepartment of Medicine, University of Arizona, Tucson, Arizona, USA.
Joseph H JooDepartment of Medicine, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-3073-0237
Fernando A WilsonMatheson Center for Health Care Studies, University of Utah, Salt Lake City, Utah, USA.

Funding

American Cancer Society DBG-23-1155771-01-HOPS
6 · The paper itself

Abstract

backgroundColorectal cancer (CRC) screening disparities persist among populations with limited health care access. Although Medicaid expansion and paid sick leave could address these barriers, there is limited data on the combined impact of these policies and CRC screening.

methodsThe authors conducted a difference-in-differences analysis using 2012-2018 Behavioral Risk Factor Surveillance System data. The study population included adults 50-75 years of age meeting preventive cancer screening guidelines during the study period. States were categorized into three groups: those with Medicaid expansion and paid sick leave (ME + SL), Medicaid expansion without paid sick leave (MEnoSL), and neither policy (NoME/NoSL). The pre-policy period was 2012-2014 and the post-policy period was 2015-2018. The outcome was the percent up-to-date with CRC screening. Survey-weighted logistic regression models accounted for individual- and state-level covariates and state-clustered standard errors.

resultsPost-policy implementation, CRC up-to-date screening was 2.9 percentage points greater in ME + SL states compared to MEnoSL states (p < .001) and 4.2 percentage points greater compared to NoME/NoSL states (p = .018). These changes correspond to an estimated 352,343 and 1,087,140 fewer missed screenings between ME + SL and MEnoSL and NoME/NoSL states, respectively. The increased percent of up-to-date CRC screenings was associated with a reduction in colorectal cancer deaths: 8456 from ME + SL versus MEnoSL and 26,091 from ME + SL versus NoME/NoSL.

conclusionsMedicaid expansion combined with paid sick leave was associated with a greater likelihood of being up-to-date with CRC screening compared to Medicaid expansion alone or neither policy.

Indexed as

Colorectal NeoplasmsEarly Detection of CancerMedicaidSick LeaveAgedBehavioral Risk Factor Surveillance SystemFemaleHealth Services AccessibilityHumansMaleMass ScreeningMiddle AgedUnited Statescancer screeningcolorectal cancerhealth insurancehealth policysick leave

Identifiers

PMID40347451
PMCPMC12065529

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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.