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Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer
Female breast cancer is a common cancer in young adults, an age group with the highest uninsured rate. Among 51 675 young adult women (ages 18-39 years) diagnosed with breast cancer between 2011 and 2018 in the National Cancer Database, we estimated changes in guideline-concordant treatment receipt,...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10534051/ https://www.ncbi.nlm.nih.gov/pubmed/37707583 http://dx.doi.org/10.1093/jncics/pkad067 |
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author | Ji, Xu Shi, Kewei Sylvia Ruddy, Kathryn J Zhao, Jingxuan Mertens, Ann C Yabroff, K Robin Castellino, Sharon M Han, Xuesong |
author_facet | Ji, Xu Shi, Kewei Sylvia Ruddy, Kathryn J Zhao, Jingxuan Mertens, Ann C Yabroff, K Robin Castellino, Sharon M Han, Xuesong |
author_sort | Ji, Xu |
collection | PubMed |
description | Female breast cancer is a common cancer in young adults, an age group with the highest uninsured rate. Among 51 675 young adult women (ages 18-39 years) diagnosed with breast cancer between 2011 and 2018 in the National Cancer Database, we estimated changes in guideline-concordant treatment receipt, treatment timeliness, and survival associated with the Affordable Care Act Medicaid expansion. Of young adults with stage I-III estrogen receptor–positive or progesterone receptor–positive breast cancer, Medicaid expansion was associated with a net increase of 2.42 percentage points (95% confidence interval [CI] = 0.56 to 4.28 percentage points) in the percentage receiving endocrine therapy. Among all young adults with stage I-III breast cancer, Medicaid expansion was associated with a net reduction of 1.65 percentage points (95% CI = 0.08 to 3.22 percentage points) in treatment delays defined as treatment initiation of at least 60 days after diagnosis and a net increase of 1.00 percentage points (95% CI = 0.21 to 1.79 percentage points) in 2-year overall survival. Our study provides evidence of benefit in cancer care and outcomes from Medicaid expansion among the young adult population. |
format | Online Article Text |
id | pubmed-10534051 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-105340512023-09-29 Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer Ji, Xu Shi, Kewei Sylvia Ruddy, Kathryn J Zhao, Jingxuan Mertens, Ann C Yabroff, K Robin Castellino, Sharon M Han, Xuesong JNCI Cancer Spectr Brief Communications Female breast cancer is a common cancer in young adults, an age group with the highest uninsured rate. Among 51 675 young adult women (ages 18-39 years) diagnosed with breast cancer between 2011 and 2018 in the National Cancer Database, we estimated changes in guideline-concordant treatment receipt, treatment timeliness, and survival associated with the Affordable Care Act Medicaid expansion. Of young adults with stage I-III estrogen receptor–positive or progesterone receptor–positive breast cancer, Medicaid expansion was associated with a net increase of 2.42 percentage points (95% confidence interval [CI] = 0.56 to 4.28 percentage points) in the percentage receiving endocrine therapy. Among all young adults with stage I-III breast cancer, Medicaid expansion was associated with a net reduction of 1.65 percentage points (95% CI = 0.08 to 3.22 percentage points) in treatment delays defined as treatment initiation of at least 60 days after diagnosis and a net increase of 1.00 percentage points (95% CI = 0.21 to 1.79 percentage points) in 2-year overall survival. Our study provides evidence of benefit in cancer care and outcomes from Medicaid expansion among the young adult population. Oxford University Press 2023-09-14 /pmc/articles/PMC10534051/ /pubmed/37707583 http://dx.doi.org/10.1093/jncics/pkad067 Text en © The Author(s) 2023. Published by Oxford University Press. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Brief Communications Ji, Xu Shi, Kewei Sylvia Ruddy, Kathryn J Zhao, Jingxuan Mertens, Ann C Yabroff, K Robin Castellino, Sharon M Han, Xuesong Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer |
title | Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer |
title_full | Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer |
title_fullStr | Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer |
title_full_unstemmed | Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer |
title_short | Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer |
title_sort | medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer |
topic | Brief Communications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10534051/ https://www.ncbi.nlm.nih.gov/pubmed/37707583 http://dx.doi.org/10.1093/jncics/pkad067 |
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