Study: ACA leads to earlier breast cancer diagnoses

The Affordable Care Act (ACA) is being credited for a shift to earlier breast cancer diagnoses as more women were able to afford mammography screening, according to a study published in the August issue of Cancer Epidemiology.

Researchers from Loyola University Chicago found that the shift to stage I diagnoses was even greater among African American and Latina breast cancer patients than in white patients (Cancer Epidemiol, August 2017, Vol. 49, pp. 108-111).

The ACA eliminated co-payments and other out-of-pocket costs for 45 preventive care services, including mammograms. The law's provision resulted in more affordable mammograms, which potentially led to earlier diagnoses, according to a release from the university.

The findings coincide with those of a May 2017 study from the American Cancer Society (ACS), which credited the ACA for a shift to earlier diagnosis for patients with breast, colorectal, and lung cancer. The ACS suggested the availability of health insurance prompted individuals to seek screening services that might detect cancers earlier.

In the current study, lead author Abigail Silva, PhD, and colleagues analyzed results from 470,465 breast cancer patients between the ages of 50 and 74 who were covered by private insurance or Medicare. They examined cancer diagnoses over two time periods: 2007 to 2009, before the Affordable Care Act took effect, and 2011 to 2013, after the law took effect.

Overall, the percentage of breast cancers that were diagnosed at stage I increased 3.6 percentage points, from 54.4% to 58.0%. The shift toward stage I breast cancer diagnoses increased by 3.2 percentage points among whites, 4.0 percentage points among African Americans, and 4.1 percentage points among Latinas.

There was a corresponding decrease in stage II and stage III diagnoses, while the proportion of stage IV cancers did not change.

The researchers recommended that additional studies be conducted to evaluate the impact of the ACA on cancer outcomes and disparities to inform future policy recommendations.

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