With cost barriers to mammography removed, more African American and Latino women were diagnosed early.
While Senate Republicans’ vote on a bill to replace the Affordable Care Act (ACA) sits on ice until after the July 4 holiday, research from Loyola University Chicago and published in the journal Cancer Epidemiology suggests an ACA success story in reducing healthcare disparities around breast cancer detection.
Mammograms are one of 45 preventive care services for which the ACA eliminated copayments and other out-of-pocket costs. After this change took effect, the rate of women diagnosed with breast cancer—the most common cancer among women in the United States—at Stage 1 of the disease increased, particularly among some minorities.
Overall, the percentage of breast cancers that were diagnosed at Stage 1 increased 3.6 percentage points, from 54.4% from 2007-2009 to 58.0% from 2011 to 2013, according to the retrospective study of 470,465 breast cancer patients between the ages of 50 and 74 who were covered by private insurance or Medicare and were newly diagnosed with Stage 1-4 cancer.
When comparing the two study periods, there was a corresponding decrease in Stage 2 and Stage 3 diagnoses, while the proportion of Stage 4 cancers did not change.
Meanwhile, the shift toward Stage 1 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, thus slightly decreasing a disparity in early diagnosis rates compared to white women.
The earlier cancer is detected, the more effectively it can be treated, noted Abigail Silva, PhD, MPH, and colleagues. Diagnosing breast cancer when it is still in Stage 1 could improve the prognosis for thousands of women and reduce the need for invasive treatments such as chemotherapy for a substantial number of women, they wrote.
The American Cancer Society estimates nearly 253,000 women will be diagnosed with breast cancer this year.
Researchers concluded that further studies to evaluate the impact of the ACA on cancer outcomes and disparities "should be supported as they will help inform future policy recommendations."
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.