A new study by researchers at the American Cancer Society (ACS) showed Medicaid expansion under the Patient Protection and Affordable Care Act may improve access to non-small cell lung cancer (NSCLC) care and outcomes across the cancer control continuum, from early-stage diagnosis, treatment initiation, and overall survival. The findings [were] presented at the annual American Society of Clinical Oncology (ASCO) Quality Care Symposium in San Francisco, September 27–28, 2024.

In the study, led by Dr. Jingxuan Zhao, senior scientist, health services research at the American Cancer Society and presented at the conference by Dr. Xuesong Han, researchers identified individuals newly diagnosed at age 18 to 64 with Stages I-IV first primary NSCLC between 2008 and 2019 in 50 states and Washington, D.C., from the National Cancer Database.

They examined the associations of Medicaid expansion with (1) diagnosis stage; (2) timely initiation of guideline-concordant treatment; (3) receipt of guideline-concordant treatment; and (4) five-year overall survival. They applied a difference-in-differences (DD) approach to examine the changes in study outcomes associated with Medicaid expansion, controlling for key sociodemographic and clinical factors.

The study showed the percentage of early-stage diagnoses increased from 23.1% pre-expansion to 31.9% post-expansion in expansion states and from 22.3% to 29.5% in non-expansion states, translating to a greater increase in early-stage diagnosis of 1.7 percentage points in expansion states after adjustment. Medicaid expansion was also associated with greater increases in timely initiation of guideline-concordant care and five-year overall survival.

Researchers emphasized findings from this study can inform efforts to expand Medicaid in the 10 states that have yet to do so.

This news release was published by the American Cancer Society on September 23, 2024.