Treatment for Younger Adults With CRC Improved Under ACA
Timely receipt of adjuvant chemo more likely in DCE-eligible patients with resected stage IIB to IIIC CRC
THURSDAY, Dec. 19, 2019 (HealthDay News) -- Implementation of the Dependent Coverage Expansion (DCE) under the Affordable Care Act (ACA) increased early-stage colorectal cancer (CRC) diagnosis and receipt of timely adjuvant chemotherapy for surgically resected stage IIB to IIIC CRC among DCE-eligible patients, according to a study published online Dec. 19 in the Journal of the National Cancer Institute.
Leticia Nogueira, Ph.D., from the American Cancer Society in Atlanta, and colleagues examined the impact of the DCE under the ACA on receipt of CRC treatment in a study involving 1,924 newly diagnosed DCE-eligible (aged 19 to 25 years) and 8,313 DCE-ineligible (aged 27 to 34 years) CRC patients from 2007 to 2013.
The researchers observed a statistically significant increase in early-stage CRC diagnosis among DCE-eligible patients (15 percent increase; 95 percent confidence interval [CI], 9.8 to 20.2; P < 0.001), but not among DCE-ineligible patients (4.4 percent increase; 95 percent CI, −0.8 to 9.6; P = 0.09), after ACA implementation. After ACA implementation, the likelihood of receiving timely adjuvant chemotherapy after surgical resection of stage IIB to IIIC CRC was increased in DCE-eligible patients (hazard ratio, 1.34; 95 percent CI, 1.05 to 1.71; 7.0-day decrease in restricted mean time from surgery to chemotherapy; P = 0.01); no differences were seen in DCE-ineligible patients (hazard ratio, 1.10; 95 percent CI, 0.98 to 1.24; 2.1 day decrease; P = 0.41).
"Although it is too early to examine differences in survival, our study is the first to report improved receipt of potentially life-saving cancer treatment as part of ACA implementation," the authors write.