Mammography Use Among Medicare Beneficiaries After Elimination of Cost Sharing

Sabatino, Susan A.; Thompson, Trevor; Guy, Gery P.; Moor, Janet S. de; Tangka, Florence

doi:10.1097/mlr.0000000000000495

Cited by 21 publications

(25 citation statements)

References 24 publications

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“…Consistent with other studies, we found that adults aged 65 and older with Medicare and public insurance or Medicare, no supplemental insurance have lower screening rates than individual with Medicare and private insurance (Klabunde et al, 2011; Sabatino et al, 2016). However, in multivariable adjusted analyses, only differences between Medicare and private insurance and Medicare, no supplemental insurance were statistically significant.…”

Section: Discussionsupporting

confidence: 92%

Colorectal cancer screening in the United States: Trends from 2008 to 2015 and variation by health insurance coverage

Moor

Cohen

Shapiro

et al. 2018

Preventive Medicine

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123

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Regular colorectal cancer (CRC) screening is recommended for reducing CRC incidence and mortality. This paper provides an updated analysis of CRC screening in the United States (US) and examines CRC screening by several features of health insurance coverage. Recommendation-consistent CRC screening was calculated for adults aged 50–75 in 2008, 2010, 2013 and 2015 using data from the National Health Interview Survey. CRC screening prevalence in 2015 was described overall and by sociodemographic subgroups. CRC screening by health insurance coverage was further examined using multivariable logistic regression, stratified by age (50–64 years and 65–75 years) and adjusted for age, race/ethnicity, sex, education, income, time in US, and comorbid conditions. Recommendation-consistent screening increased from 51.6% in 2008 to 58.3% in 2010 (p < 0.001). Use plateaued from 2010 to 2013 but increased to 61.3% in 2015 (p < 0.001). In 2015, adults aged 50–64 years with traditional employer-sponsored private insurance were more likely to be screened (62.2%) than those with traditional private direct purchase plans (50.9%) and the uninsured (24.8%) (p < 0.01, respectively). After multivariable adjustment, differences between traditional employer-sponsored private insurance and the uninsured remained statistically significant. Adults aged 65–75 with Medicare and private insurance were more likely to be screened (76.3%) than those with Medicare, no supplemental insurance (68.8%) or Medicare and Medicaid (65.2%) (p < 0.001). After multivariable adjustment, the differences between Medicare and private insurance and Medicare no supplemental insurance remained statistically significant. CRC screening rates have increased over time, but certain segments of the population, especially the uninsured, continue to screen below recommended levels.

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Section: Discussionsupporting

confidence: 92%

Colorectal cancer screening in the United States: Trends from 2008 to 2015 and variation by health insurance coverage

Moor

Cohen

Shapiro

et al. 2018

Preventive Medicine

Self Cite

123

View full text Add to dashboard Cite

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“…The differences in stages at diagnosis are essentially due to disparities in health services availability, a highly prevalent situation in Latin America and other developing countries, but also already reported in the USA 15,16 , Europe 6,17 and other countries of the world. In fact, an analysis of GLOBOCAN statistics has been conducted, demonstrating that breast cancer-related mortality is directly associated with the Human Development Index 18 , with one of the reasons being late detection, aggravated by unavailability of best treatments.…”

Section: Discussionmentioning

confidence: 99%

Disparities in Breast Cancer Characteristics in Mexico

Medina‐Franco¹,

Gaona-Luviano²

2022

GAMO

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Introduction: There are no data on breast cancer epidemiological characteristics of patients treated in the private medicine setting in Mexico. Methods: A retrospective study of women treated in a private tertiary health center in Mexico City from 2001 to 2016 was carried out, and a comparison was made with data of the National Institute of Cancer (InCan). Results: A total of 240 patients with a median age of 52 years were included. The most common histologic subtype was ductal carcinoma, with most cases corresponding to the luminal immunophenotype. Tumors were detected by radiologic screening in 34% of cases, and in 41.7%, tumors were diagnosed in situ or at stage I, in comparison with the InCan series, where 48% are stages III and IV (p < 0.01). Of the cases detected by self-palpation, half had lymph node metastases vs. 7% in the screening-detected cases (p < 0.001). In 60%, conservative surgery was performed, and in 13%, mastectomy with immediate reconstruction. Five-year disease-free survival is higher than 90%. Conclusions: Breast cancer epidemiology is consistent with InCan statistics. There is significant difference in clinical stages at presentation, which is attributed to disparity in access to screening. (creativecommons.org/licenses/by-nc-nd/4.0/). Disparities in breast cancer characteristics in Mexico 92

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“…Nonetheless, there is evidence from multiple studies of increases in screening in the Medicare population after the ACA was implemented. 14,16,18–21 Further, a recent study considering changes in early stage diagnoses of cancer among Medicare-aged individuals compared to younger cohorts and found a significant increase in early-stage colorectal cancer diagnoses (and decrease in late-stage diagnoses among men) though no evidence of changes in breast cancer stage. 22 …”

Section: Resultsmentioning

confidence: 99%

“…20 Another study found that among women with Medicare, there was a modest increase in mammography screening after the elimination of cost-sharing. 21 Notably, none of the studies considering the impact of cost-sharing elimination for Medicare beneficiaries were able to compare changes in screening to a valid control group, limiting the ability to draw robust conclusions regarding causality. Nonetheless, there is evidence from multiple studies of increases in screening in the Medicare population after the ACA was implemented.…”

Section: Resultsmentioning

confidence: 99%

The ACA and Cancer Screening and Diagnosis

Sabik¹,

Adunlin²

2017

Cancer J

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The Affordable Care Act (ACA) included multiple provisions expected to increase cancer screening and subsequently early diagnosis of cancer. Key provisions included new coverage options for low-income adults and young adults, as well as elimination of cost-sharing for recommended preventive services across most health insurance plans. This paper reviews relevant quantitative studies published since the ACA’s passage to assess whether the goal of increasing access to preventive services has been met. Due to lags in data availability, most studies examined only a short time period post-ACA. Findings on changes in screening in the general population were mixed, though impacts were greatest among those with lower education and income, as well as groups that previously faced the highest cost-barriers to screening. Further, multiple studies found evidence of increases in early stage diagnoses for certain cancers. Thus, certain targeted populations appear to have better access to cancer screening after the ACA.

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Mammography Use Among Medicare Beneficiaries After Elimination of Cost Sharing

Cited by 21 publications

References 24 publications

Colorectal cancer screening in the United States: Trends from 2008 to 2015 and variation by health insurance coverage

Colorectal cancer screening in the United States: Trends from 2008 to 2015 and variation by health insurance coverage

Disparities in Breast Cancer Characteristics in Mexico

The ACA and Cancer Screening and Diagnosis

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