Evaluating the role of medicaid expansion on survival in early onset colorectal cancer.
코호트
2/5 보강
PICO 자동 추출 (휴리스틱, conf 2/4)
유사 논문P · Population 대상 환자/모집단
환자: CRC <65 years were included in primary analyses; a EOCRC cohort aged <50 years was examined
I · Intervention 중재 / 시술
추출되지 않음
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
[CONCLUSION] Medicaid expansion under the ACA was associated with a high probability of improved CRC survival among non-Medicare-eligible adults, including patients with early-onset disease. Survival gains occurred without corresponding changes in stage or surgical treatment, suggesting benefits mediated through improved access, continuity, and delivery of cancer care.
OpenAlex 토픽 ·
Healthcare Policy and Management
Economic and Financial Impacts of Cancer
Global Cancer Incidence and Screening
[BACKGROUND] The Affordable Care Act (ACA) expanded Medicaid eligibility to states on staggered timelines, creating a natural experiment to assess health policy effects on colorectal cancer (CRC) outc
- HR 0.86
- 연구 설계 cohort study
APA
Rohin Gawdi, Elizabeth Nilsson Sjolander, et al. (2026). Evaluating the role of medicaid expansion on survival in early onset colorectal cancer.. Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/djag109
MLA
Rohin Gawdi, et al.. "Evaluating the role of medicaid expansion on survival in early onset colorectal cancer.." Journal of the National Cancer Institute, 2026.
PMID
41950384 ↗
Abstract 한글 요약
[BACKGROUND] The Affordable Care Act (ACA) expanded Medicaid eligibility to states on staggered timelines, creating a natural experiment to assess health policy effects on colorectal cancer (CRC) outcomes.
[METHODS] We conducted a retrospective quasi-experimental cohort study using the SEER database (2006 to 2019). Patients with CRC <65 years were included in primary analyses; a EOCRC cohort aged <50 years was examined. States were classified by Medicaid expansion timing, and each expansion group was propensity score-matched against non-expansion controls. The primary analysis used pooled Bayesian difference-in-differences survival models with censoring at 36 months, with sensitivity analyses at 60 months and uncapped follow-up. Secondary Bayesian logistic models evaluated stage at diagnosis and receipt of surgical resection. Results are reported as hazard ratios (HR) or odds ratios (OR) with 95% credible intervals (CrI) and posterior probabilities of benefit.
[RESULTS] In pooled analyses among patients younger than 65 years, Medicaid expansion was associated with reduced mortality (36-month HR = 0.86; 95%CrI, 0.81 to 0.92; P(HR < 1)>0.999), with consistent findings across follow-up endpoints. Survival benefit was larger among patients with early-onset CRC (age <50 years). No consistent association was observed among Medicare-eligible patients aged ≥65. Medicaid expansion was not associated with population-level shifts in stage at diagnosis or increased surgical resection.
[CONCLUSION] Medicaid expansion under the ACA was associated with a high probability of improved CRC survival among non-Medicare-eligible adults, including patients with early-onset disease. Survival gains occurred without corresponding changes in stage or surgical treatment, suggesting benefits mediated through improved access, continuity, and delivery of cancer care.
[METHODS] We conducted a retrospective quasi-experimental cohort study using the SEER database (2006 to 2019). Patients with CRC <65 years were included in primary analyses; a EOCRC cohort aged <50 years was examined. States were classified by Medicaid expansion timing, and each expansion group was propensity score-matched against non-expansion controls. The primary analysis used pooled Bayesian difference-in-differences survival models with censoring at 36 months, with sensitivity analyses at 60 months and uncapped follow-up. Secondary Bayesian logistic models evaluated stage at diagnosis and receipt of surgical resection. Results are reported as hazard ratios (HR) or odds ratios (OR) with 95% credible intervals (CrI) and posterior probabilities of benefit.
[RESULTS] In pooled analyses among patients younger than 65 years, Medicaid expansion was associated with reduced mortality (36-month HR = 0.86; 95%CrI, 0.81 to 0.92; P(HR < 1)>0.999), with consistent findings across follow-up endpoints. Survival benefit was larger among patients with early-onset CRC (age <50 years). No consistent association was observed among Medicare-eligible patients aged ≥65. Medicaid expansion was not associated with population-level shifts in stage at diagnosis or increased surgical resection.
[CONCLUSION] Medicaid expansion under the ACA was associated with a high probability of improved CRC survival among non-Medicare-eligible adults, including patients with early-onset disease. Survival gains occurred without corresponding changes in stage or surgical treatment, suggesting benefits mediated through improved access, continuity, and delivery of cancer care.