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CRC screenings triple after Medicaid expansion in Kentucky
The number of patients who were screened for colorectal cancer in Kentucky increased by more than 200% after Medicaid expanded in the state in 2014, according to data published in the Journal of the American College of Surgeons.
Avinash S. Bhakta, MD, of the University of Kentucky Markey Cancer Center, said in a press release that he started seeing more patients from the state’s rural, Appalachian population, and wanted to explore exactly how the Affordable Care Act and Medicaid expansion was impacting the state’s population.
“For me, it was a bit of a wake-up call living in our society and seeing the population that I treat in Kentucky, particularly in Appalachia,” he said in the release. “Many of these patients paved their own roads to come see me in Lexington. We didn’t really see much study on the effect of the Affordable Care Act Medicaid expansion, and with our population having the leading incidence and mortality rate of CRC in the country, we felt that it was an ideal population to study this potential impact.”
Researchers analyzed data from the Kentucky Hospital Discharge Database and the Kentucky Cancer Registry to identify patients older than 20 years who underwent CRC screening from 2011 through 2016. More than 930,000 patients were screened over the course of the study period, with 408,500 screened before Medicaid expansion and 521,676 screened after.
When they looked at just patients with Medicaid, investigators found that the number of patients who underwent CRC screening increased from 20,980 before expansion to 69,328 after expansion. Patients from the state’s Appalachian region experienced the highest increase in screening (44% improvement) compared with non-Appalachian patients (22% improvement; P < .01).
As patients from the Appalachian region experienced better CRC survival after Medicaid expansion, survival in the state improved overall (HR = 0.73; P < .01).
Now that they have these data, Bhakta said that they need additional research to find solutions for the state’s mortality rate, which remains high.
“After these individuals are screened and diagnosed with colorectal cancer, are we not navigating them appropriately to surgery? After their operations, are the patients with advanced tumors not getting chemotherapy in a timely fashion?” Bhakta asked in the release. “Finally, is this patient population that we treat at UK Markey Cancer Center resistant to traditional chemotherapeutic agents? These questions and barriers are important for us to investigate in order to continue our fight against colorectal cancer.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.