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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,...

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Autores principales: Ji, Xu, Shi, Kewei Sylvia, Ruddy, Kathryn J, Zhao, Jingxuan, Mertens, Ann C, Yabroff, K Robin, Castellino, Sharon M, Han, Xuesong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
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.
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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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