Metastatic breast cancer survival rates are up in Medicaid expansion states
Metastatic breast cancer survival rates increased for patients residing in 19 states that underwent Medicaid expansion on Jan. 1, 2014, a new study published in JAMA Oncology found.
Led by Susan G. Komen Scholars, the study looked at medical outcomes for 9,322 metastatic breast cancer patients from those states, all of whom were diagnosed between 2010 and 2016. All patients included in the study were between ages 40 and 64, making them too young to be eligible for Medicare.
For the entire study population, two-year mortality rates decreased from 33.6% in 2010 to 25.6% in 2015.
The study’s authors also highlighted notable decreases in racial disparities when comparing mortality rates prior to Medicaid expansion with the post-expansion period. Among patients belonging to racial or ethnic minority groups, two-year mortality (adjusted for confounding variables) fell from 45.6% in the pre-expansion period to 35.8% in the post-expansion period. Among white patients, two-year adjusted mortality fell from 40.6% to 36.3%.
“It is possible that the use of novel therapeutics during the study time was associated with improved outcomes. However, the differential improvement among racial and ethnic minority group participants suggests that access to health care likely played an important role,” writes first author Catalina Malinowski, MPH, CHES, CHW, with the University of Texas MD Anderson Cancer Center in Houston, and colleagues.
Prior to the Medicaid expansion, 6.7% of the study population was uninsured. Post-expansion, just 3.6% of the study population was uninsured.
“This study makes clear that policies that increase access to health care reduce disparities in people with metastatic breast cancer,” Sharon Giordano, MD, MPH, study author and Komen Scholar, said in a statement. “There are no cures for metastatic breast cancer and improved survival is critical for people living with the disease regardless of their socioeconomic status or ethnicity.”
The study did not analyze comparable mortality data from states that did not participate in Medicaid expansion.
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