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

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.

SUBMITTER: Silva A 

PROVIDER: S-EPMC5544537 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature