scholarly journals Association of Medicaid expansion and insurance status, cancer stage, treatment and mortality among patients with cervical cancer

2021 ◽  
Author(s):  
Grace Lee ◽  
Edward Christopher Dee ◽  
E. John Orav ◽  
Daniel W. Kim ◽  
Paul L. Nguyen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Insurance Status ◽  
Cancer Stage ◽  
Medicaid Expansion

scholarly journals Association of Insurance Status and Age With Cervical Cancer Stage at Diagnosis: National Cancer Database, 2000–2007

2012 ◽  
Vol 102 (9) ◽  
pp. 1782-1790 ◽  
Author(s):  
Stacey A. Fedewa ◽  
Vilma Cokkinides ◽  
Katherine S. Virgo ◽  
Priti Bandi ◽  
Debbie Saslow ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Insurance Status ◽  
Cancer Stage ◽  
National Cancer Database ◽  
Stage At Diagnosis

The association between the Affordable Care Act on insurance status, cancer stage, and overall survival in patients with renal cell carcinoma.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 281-281
Author(s):  
Juan Javier-Desloges ◽  
Julia Yuan ◽  
Shady Soliman ◽  
Kevin Hakimi ◽  
Margaret Frances Meagher ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Affordable Care Act ◽  
Low Income ◽  
Cox Regression ◽  
Stage Migration ◽  
Insurance Status ◽  
Cancer Stage ◽  
Medicaid Expansion ◽  
Middle Income ◽  
Income Status

281 Background: We aimed to determine whether insurance expansions implemented through the Patient Protection and Affordable Care Act (ACA) were associated with changes in insurance coverage status, stage at diagnosis, and overall survival for patients with renal cell carcinoma (RCC). Methods: We identified patients 40 to 64 years old diagnosed with RCC between 2010 and 2016 in the National Cancer Database. States were categorized as participating on time in Medicaid expansion or not participating. We stratified patients into advanced cancer (stage III + IV) and localized cancer (stage I + II) groups. We stratified patients into low, middle, and high income groups. Stage trend and insurance trend analysis were performed to based on income status amongst patients living in expansion and non-expansion states. Absolute percentage change (APC) was calculated for insurance status and stage migration. Cox Regression Multivariable Analysis was conducted to assess risk of all-cause mortality (ACM) for patients before and after the implementation of the ACA, adjusting for insurance status, income, education, age, race, ethnicity, comorbidity, and living in an expansion state. Results: We identified 78,099 patients who met inclusion criteria. Following implementation of ACA, APC of patients with insurance increased in both Medicaid and non-expansion states by 4.0% and 2.10% (p<0.01), respectively. The largest increases occurred in expansion states, with low income patients acquiring Medicaid (APC +11.0% p<0.01), middle income patients acquiring Medicaid (APC +8.20% p<0.01), and high-income patients acquiring Medicaid (APC +4.0% p<0.01). In our stage trend analysis, there was a higher proportion of patients with localized stage disease after the implementation of the ACA in low income (APC +4.0% p<0.01) and middle-income patients (APC +1.6% p=0.02.) who live in expansions states, as well as middle income patients in non-expansions states (APC 1.4% p=0.02). Cox Regression MVA revealed that before ACA implementation, low income and middle income were associated with higher risk of mortality (HR 1.29 95%CI 1.18-1.40 p<0.01) and (HR 1.18 95% CI 1.10-1.26, p<0.01, but was not following ACA implementation (p=0.20) and (p=0.05) respectively. Conclusions: Following the implementation of the ACA the proportion of patients with newly diagnosed RCC with health insurance increased with the largest effects seen in Medicaid expansions states. In addition, higher proportions of patients were diagnosed with localized disease in Medicaid expansion states amongst low- and middle-income patients. Furthermore, income status ceased being a risk factor for mortality following ACA implementation. Our findings suggest that ACA implementation has been associated with downward stage migration in low/middle-income patients and attenuation of income status as a risk for mortality in RCC.

scholarly journals Management of cervical cancer stage Ib1 with poor prognosis during pregnancy: two

2012 ◽  
Vol 4 ◽  
pp. 291-295 ◽  
Author(s):  
Maja Kufelnicka-Babout ◽  
Dorota Kolasa-Zwierzchowska ◽  
Grzegorz Stachowiak ◽  
Małgorzata Zielińska ◽  
Hanna Romanowicz-Makowska ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Poor Prognosis ◽  
Cancer Stage

Beyond Insurance Status: The Impact of Medicaid Expansion on the Diagnosis of Hepatocellular Carcinoma

HPB ◽  
2022 ◽  
Author(s):  
Marianna V. Papageorge ◽  
Alison P. Woods ◽  
Susanna W.L. de Geus ◽  
Sing Chau Ng ◽  
Michael K. Paasche-Orlow ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Insurance Status ◽  
Medicaid Expansion ◽  
The Impact
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