Advanced-stage colon cancer diagnoses declined after Massachusetts expanded health insurance coverage, a new study finds.
In 2006, state legislators passed a health insurance reform law with the aim of providing health care access to nearly all residents.
"Colorectal cancer frequently occurs in adults under 65 who are not yet eligible for Medicare. And we know from previous research that people who do not have health insurance or who are underinsured are less likely to get recommended preventive health screenings," said study lead author Lindsay Sabik. She's an associate professor of health policy and management at the University of Pittsburgh.
"Cancer is only one disease area where preventive care and early diagnosis can make a big difference in survival and cost of treatment," she said in a university news release. "Our study demonstrates the public health value of expanded health insurance coverage."
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For the study, Sabik and her colleagues analyzed Massachusetts Cancer Registry data from 2001 through 2013. The investigators found a 7 percent decline in the likelihood of advanced-stage colorectal cancer diagnosis among 50- to 64-year-olds after insurance reforms, compared with trends in other states.
The decline likely owed to increased access to screening and diagnostic services that identified colon cancers earlier, the study authors suggested. The findings were published in the February issue of the journal Medical Care.
Colorectal cancer is the second-leading cause of cancer death in the United States, and the U.S. Preventive Services Task Force recommends routine screening starting at age 50.
The survival rate is 90 percent when the cancer is treated early, but that rate drops significantly when it is more advanced at diagnosis, the study authors noted.
Extending the Massachusetts findings to the entire United States, Sabik's team estimated there would be 2,100 fewer late-stage colorectal cancer diagnoses a year among non-elderly people.
In the United States, colorectal cancer care costs about $16.3 billion a year, according to the U.S. National Cancer Institute.
"Our study is the first to present evidence that Massachusetts' health reform may be associated with a shift to earlier-stage diagnosis for a cancer that has a high cure rate when caught early," Sabik said.
"This is exciting because key elements of the Affordable Care Act parallel those of the Massachusetts reform. While data on the long-term impacts are still emerging, we expect that early cancer diagnosis will likely be one of the major success stories of national health insurance reform," she said.
More information
The U.S. National Cancer Institute has more on colon cancer screening.
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