The Impact of Massachusetts Health Reform on Colorectal and Breast Cancer Stage at Diagnosis
Bibliographic Data
| ID | 9100478 |
|---|---|
| Authors | Lindsay M Sabik (0000-0002-0613-4929, University of Pittsburgh, corresponding author), Kirsten Y Eom (University of Pittsburgh), Kirsten Eom (0000-0003-3809-2978, University of Pittsburgh, corresponding author), Bassam Dahman (0000-0001-7209-5369, Virginia Commonwealth University), Jie Li (0000-0002-5131-4769, University of Pittsburgh, corresponding author), Nengliang Yao (0000-0001-9000-0378, University of Virginia), G J van Londen (0000-0001-6047-6172, University of Pittsburgh), Cathy J Bradley (0000-0001-8586-8009, University of Colorado Comprehensive Cancer Center, Aurora, CO) |
| Year | 2020 |
| Volume | 58 |
| Issue | 2 |
| Pages | 183-191 |
| Publication date | 2020-02-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001241 |
| PMID | 31934958 |
| OpenAlex | W3000128836 |
| Language | EN |
| Citations received | 1 |
| References cited | 39 |
BACKGROUND: This study examines the expansion of health insurance coverage in Massachusetts under state health reform as a natural experiment to investigate whether expanded insurance coverage reduced the likelihood of advanced stage colorectal cancer (CRC) and breast cancer (BCA) diagnosis. METHODS: Our study populations include CRC or BCA patients aged 50-64 years observed in the Massachusetts Cancer Registry and Surveillance Epidemiology and End Results (SEER) registries for 2001-2013. We use difference-in-differences regression models to estimate changes in the likelihood of advanced stage diagnosis after Massachusetts health reform, relative to comparison states without expanded coverage (Connecticut, New Jersey, Georgia, Kentucky, and Michigan). RESULTS: We find some suggestive evidence of a decline in the proportion of advanced stage CRC cases. Approximately half of the CRC patients in Massachusetts and control states were diagnosed at advanced stages pre reform; there was a 2 percentage-point increase in this proportion across control states and slight decline in Massachusetts post reform. Adjusted difference-in-difference estimates suggest a 3.4 percentage-point (P=0.005) or 7% decline, relative to Massachusetts baseline, in the likelihood of advanced stage diagnosis after the reform in Massachusetts, though this result is sensitive to years included in the analysis. We did not find a significant effect of reform on BCA stage at diagnosis. CONCLUSIONS: The decline in the likelihood of advanced stage CRC diagnosis after Massachusetts health reform may suggest improvements in access to health care and CRC screening. Similar declines were not observed for BCA, perhaps due to established BCA-specific safety-net programs
Breast cancer · Cancer · Cancer registry · Colorectal cancer · Pathology · Public health · Stage (stratigraphy) · Demography · Economic and Financial Impacts of Cancer · Epidemiology · Global Cancer Incidence and Screening · Healthcare Policy and Management · Internal Medicine · Medicine · Gerontology
Designing Difference in Difference Studies
Cancer statistics, 2018
Projections of the Cost of Cancer Care in the United States
Health Reform
Breast and Cervical Cancer Screening
Medicaid Coverage Expansion and Implications for Cancer Disparities
Factors Explaining Racial/Ethnic Disparities in Rates of Physician Recommendation for Colorectal Cancer Screening
Association of State Dense Breast Notification Laws With Supplemental Testing and Cancer Detection After Screening Mammography
Late Stage Cancers in a Medicaid-insured Population
| Unique citing works | 1 |
|---|---|
| Citations per year | 0,17 |
| Citation span | 2020 - 2020 (1) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 1 |