In states where Medicaid was expanded under the Affordable Care Act (ACA), women are more likely to receive breast cancer diagnoses at an early stage, compared with women in other states, new research shows.<\/p>\n\n\n
Among women younger than 50, the average rate of diagnosis at advanced stages lowered from 23% to 21% between 2012-13 (before most states expanded Medicaid) and 2015-16 (after expansion), according to a Yale Cancer Center<\/a> study published today in JAMA Surgery. In states where Medicaid wasn\u2019t expanded, the average rate of advanced-stage diagnoses stayed constant at 26% during those years.<\/p>\n\n\n \u201cIt\u2019s a small percentage change [in expansion states] but it was statistically significant,\u201d said Dr. Tristen Park, senior author of the study and a breast cancer surgeon at the Yale Cancer Center and Smilow Cancer Hospital,<\/a> especially since the drop was evident over just a few years. \u201cIt\u2019s quite exciting. I\u2019m impressed it\u2019s even detectable over such a short period of time. It\u2019s happening at a much quicker rate\u201d than expected.<\/p>\n\n\n She said, \u201cTime will only make this [decline] more pronounced. What we\u2019d like to see is this trend to continue and for it to remain statistically significant.\u201d<\/p>\n\n\n Nationally, the decline in late-stage detection rates was even more notable among Black women: diagnoses dropped from 25% to 21% in expansion states, with no significant difference in non-expansion states.<\/p>\n\n\n \u201cIt\u2019s great that we see that result. Generally, the African American population presents with a more aggressive type of breast cancer\u201d known as triple-negative, Park said. \u201cHaving a more aggressive biology and not having health care puts them in a vulnerable position.\u201d<\/p>\n\n\n The overall findings show that women are more likely to seek health care services when they have health insurance, Park said. They become more likely to have screenings like mammograms, but also to seek out doctors for follow-up care or if they find a lump in their breast during a self-exam.<\/p>\n\n\n In Connecticut, which was included in the study, the rate of late-stage diagnoses remained the same \u2013 at 14% \u2013 between 2012-13 and 2015-16, Park said. That likely is because Connecticut already was doing a better-than-average job connecting women to breast cancer screening and care, she said.<\/p>\n\n\n For the study, researchers examined cases of 71,235 women who were diagnosed with breast cancer in 31 states where Medicaid expanded and 14 states where it did not. The average rate of uninsured breast cancer patients fell from 23% to 14% in expansion states, whereas no significant changes were seen in non-expansion states, they found.<\/p>\n\n\n\n \u201cIt\u2019s great that we see that result. Generally, the African American population presents with a more aggressive type of breast cancer\u201d known as triple-negative. \u201cHaving a more aggressive biology and not having health care puts them in a vulnerable position.\u201d <\/strong><\/em><\/p>Dr. Tristen Park<\/strong><\/cite><\/blockquote>\n\n\n Breast cancer is the most common cancer among American women. An estimated 268,6000 women were diagnosed with new cases of invasive breast cancer nationwide in 2019, and about 25,250 of those were younger than 45, according to the Connecticut Breast Health Initiative<\/a>. In Connecticut, about 430 women died from breast cancer in 2019, making the disease the second most common cause of cancer deaths in Connecticut, behind lung cancer, according to the group.<\/p>\n\n\n Early detection is key in the battle against breast cancer, Yale researchers said \u2013 particularly among women under 50 \u2013 because the cancer is rarer and more aggressive in younger patients.<\/p>\n\n\n\n \u201cIf the cancer is diagnosed early, generally treatment is definitive and women have good overall survival,\u201d Dr. Justin Le Blanc, first author of the study and a surgical resident at Yale Cancer Center<\/a> and Smilow Cancer Hospital<\/a>, said in a statement. \u201cIt\u2019s important to get women health care access early.\u201d<\/p>\n\n\n In 2010, Connecticut became the first state in the country to expand Medicaid once the ACA allowed states to extend coverage to anyone living in a household where the income is below 138% of the federal poverty level. The current poverty level<\/a> for a family of four is a household income of $26,200.<\/p>\n\n\n Since then, 35 other states and Washington, D.C. have expanded Medicaid; and as of today 13 states have not. On Tuesday, Oklahoma voters approved a ballot measure for Medicaid expansion as of July 2021.<\/p>\n\n\n A previous study<\/a> by Yale Cancer Center, released in June 2019, analyzed more than 30,000 health records nationwide and found that the racial disparity between white and Black cancer patients when it comes to accessing timely treatments virtually disappeared in Medicaid expansion states.<\/p>\n\n\n Looking ahead, Yale researchers plan to study the medical services that are provided to patients on Medicaid compared with those provided to women on other types of insurance and the uninsured.<\/p>\n\n\n Publisher\u2019s Note:\u00a0CTLN<\/a>\u00a0and\u00a0c-hit.org<\/a>\u00a0collaborate to best serve the Connecticut Hispanic, Latino community.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" In states where Medicaid was expanded under the Affordable Care Act (ACA), women are more likely to receive breast cancer 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\n\n\nHispanic women have about a 20% lower incidence of breast cancer than the general population of the US. Incidence in the Hispanic population was 91.9 per 100,000 annually between 2008-2012, compared to 128.1 and 124.3 for NHWs and African Americans, respectively.<\/h4>\n\n\n\n
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