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Potential impact of the Affordable Care Act's preventive services provision on breast cancer stage: A preliminary assessment.

Silva A, Molina Y, Hunt B, Markossian T, Saiyed N. Potential impact of the Affordable Care Act's preventive services provision on breast cancer stage: A preliminary assessment. Cancer epidemiology. 2017 Aug 1; 49:108-111.

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Abstract:

INTRODUCTION: The Affordable Care Act's (ACA) preventive services provision (PSP) removes copayments for preventive services such as cancer screening. We examined: 1) whether a shift in breast cancer stage occurred, and 2) the impact of the provision on racial/ethnic disparities in stage. MATERIALS AND METHODS: Data from the National Cancer Database were used. The pre- and post-PSP periods were identified as 2007-2009 and 2011-2013, respectively. Proportion differences (PDs) and 95% confidence Intervals (CIs) were calculated. RESULTS: All three racial/ethnic groups experienced a statistically significant shift toward Stage I breast cancer. Pre-PSP, the black:white disparity in Stage I cancer was -9.5 (95% CI: -8.9, -10.4) and the Latina:white disparity was -5.2 (95% CI: -4.0, -6.1). Post-PSP, the disparities improved slightly. DISCUSSION: Preliminary data suggest that the ACA's PSP may have a meaningful impact on cancer stage overall and by race/ethnicity. However, more time may be needed to see reductions in disparities.





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