Evidence map›Paper›PMID 40682408›Full record

ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026

Medicaid expansion and overall mortality among women with cervical cancer.

Oluwasegun Akinyemi, Fadeke Ogunyankin, Mojisola Fasokun, Faith Abodunrin, Oluebubechukwu Eze, Phiwinhlanhla Ndebele-Ngwenya, Kailyn Geter, Kakra Hughes, Shari Lawson

Abstract read
In one paragraph

Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. 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

9 authors.

Oluwasegun AkinyemiThe Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA.
Fadeke OgunyankinDepartment of Research Data Science and Analytics, Cook Children's Health Care System: Cook Children's Medical Center, Fort Worth, Texas, USA.
Mojisola FasokunDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Faith AbodunrinDepartment of Hematology and Oncology, University of Chicago, Chicago, Illinois, USA.
Oluebubechukwu EzeThe Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA.ORCID https://orcid.org/0009-0002-5596-8492
Phiwinhlanhla Ndebele-NgwenyaThe Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA.
Kailyn GeterThe Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA.
Kakra HughesThe Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA.
Shari LawsonDepartment of Obstetrics and Gynecology, Howard University College of Medicine, Washington, DC, USA.

Funding

Sleep Disorders in Adults with Sickle Cell Disease: Frequency, Associations with Cardiovascular and Pain Indicators, and Responses to TreatmentU54MD007597 · NIMHD · HOWARD UNIVERSITY · PI BYRON D. FORD · 2019 to 2026
$37.7M
NIMHD NIH HHS 2U54MD007597NIMHD NIH HHS U54 MD007597
6 · The paper itself

Abstract

objectiveTo assess the association between Medicaid expansion under the Affordable Care Act (ACA) and overall mortality among women with cervical cancer, specifically evaluating changes in stage at diagnosis and treatment utilization and emphasizing differences in survival between early expansion states (implemented by 2014) and non-expansion states.

methodsResearchers conducted a retrospective cohort study using data from the National Cancer Database for the period 2006-2021, involving individuals aged 18-64 years. Medicaid expansion served as the primary explanatory variable, classifying states that implemented Medicaid expansion before January 2014 as early expansion states and states that did not expand as non-expansion states. The Difference-in-Differences (DID) analytical method assessed the effects of Medicaid expansion on survival, cancer stage at diagnosis, and treatment utilization, adjusting for demographics, cancer stage, treatment modalities, and incorporating state and year fixed effects. Robust standard errors were clustered at the state level.

resultsThe analysis included 77 774 women aged 18-64 years diagnosed with cervical cancer, with 37 901 (48.7%) diagnosed pre-ACA and 39 873 (51.3%) diagnosed post-ACA. In early expansion states, Medicaid expansion correlated with a 3.12% increase in early-stage cervical cancer diagnoses (95% confidence interval [CI] 1.74%-4.53%) and a 1.44 percentage point reduction in distant metastatic disease at presentation (95% CI -2.52% to -0.30%). Additionally, there was a 3.24% increase in surgical treatment utilization (95% CI 1.83%-4.62%) compared with non-expansion states. Furthermore, early expansion states demonstrated a 29.12% reduction in overall mortality hazard (95% CI -56.41% to -1.63%), with these survival improvements consistent across racial groups and disease stages.

conclusionMedicaid expansion was associated with earlier diagnosis, increased surgical treatment utilization, and significantly reduced overall mortality among women with cervical cancer.

Indexed as

MedicaidPatient Protection and Affordable Care ActUterine Cervical NeoplasmsAdolescentAdultFemaleHumansMiddle AgedNeoplasm StagingRetrospective StudiesUnited StatesYoung Adultcervical cancerDifference‐in‐Differences analysisearly diagnosishealthcare accessMedicaid expansionoverall mortalitysurvival disparitiestreatment utilization

Identifiers

PMID40682408
PMCPMC12716491

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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.