ArticleBMJ open2025
Annual cases of colon cancer by age group after Medicaid expansion in the USA in 2014: a difference-in-differences study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies examining the association between Medicaid expansion (ME) under the Affordable Care Act (ACA) and colon cancer incidence have produced mixed results.
objectiveTo re-visit the association between the ACA-ME and annual cases of colon cancer.
designDifference-in-differences (DiD).
settingThe primary analyses used data from the National Cancer Database from 2010 to 2018, a hospital-based cancer registry in the USA. We also conducted exploratory analyses using data from the Surveillance, Epidemiology and End Results (SEER) registry. PATIENTS: Patients aged 40 and older with newly diagnosed colon cancer. MEASUREMENTS: The primary outcome was the percent change in colon cancer of all stages. Secondary outcomes were percent changes in stage I and stage IV cases.
resultsAmong those aged 40-49, we observed a statistically significant greater increase in stage I colon cancer in expansion states relative to non-expansion states (DiD (percent change) 9.7% (95% CI, 2.5% to 17.4%)). In those aged 50-64, we did not observe statistically significant differences between the two state groups in any of the outcomes. Among those aged 65+, we observed a statistically significant relative decrease for all stages in ACA-ME states (-1.0% (95% CI, -1.0% to -3.0%)) and for stage IV (-3.0% (95% CI, -2.0% to -5.0%)). We explored our findings among younger individuals (<50) in trend plots comparing annual colorectal cancer cases to percent uninsured using SEER data and observed that increases in cases coincided with declining uninsurance in several states.
conclusionPost-ME, we observed a greater relative increase in colon cancer among those <50 in expansion states. Our exploratory analyses suggest that fewer barriers to healthcare post-ME may have contributed to these findings; additional studies are needed. We also observed relative decreases in the 65+ age group, corroborating previous reports of spillover benefits in expansion states.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.