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Access to the Affordable Care Act and Breast Cancer Diagnosis: Pennsylvania Perspective

By: Noelle Cutter, PhD
Posted: Wednesday, February 17, 2021

According to a study based on the Pennsylvania Cancer Registry data, increased access to health insurance per the Affordable Care Act (ACA) between 2010 and 2016 increased early-stage breast cancer diagnosis. Minority women, in particular, experienced a significant increase in early detection. Neal G. Spada, MD, of UPMC Hillman Cancer Center, Pittsburgh, and colleagues published their study findings in the Journal of Women’s Health.

“While our study suggests that the ACA has had a positive impact on breast cancer diagnosis in Pennsylvania, questions remain,” commented the study authors. “Future research should identify those disadvantaged populations for whom disparities in health care remain pronounced despite the ACA.”

In this study, changes in early-stage breast cancer diagnosis by race/ethnicity, rurality of residence, and socioeconomic status seemed to be correlated with diagnostics of early-stage breast cancer in Pennsylvania post-ACA. In women between the ages of 50 and 64, the number of early-stage breast cancer diagnoses increased by 1.7% (P < .01), compared with no change in women between the ages of 68 and 74. In addition, the investigators noted that minority women had “lower odds of early-stage breast cancer diagnosis” before ACA—but not after it.

However, higher odds of such a diagnosis were linked with increased area-level socioeconomic advantage both before and after ACA—regardless of race, area or residence, or primary care physician density.

“Defining at-risk groups for whom health-care disparities remain and noninsurance factors that contribute to those disparities will help health-care providers address these issues in everyday practice and assist policymakers in improving our health-care system.”

Disclosure: The study authors reported no conflicts of interest.



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