November 25, 2015 — An increase in the number of women under the age of 26 receiving early-stage cervical cancer diagnoses likely is linked to a provision of the Affordable Care Act that took effect in 2010, according to a study published Tuesday in the Journal of the American Medical Association, the New York Times reports.
The ACA provision allows young adults until age 26 to remain covered by their parents' health insurance. According to federal data, the number of uninsured young adults ages 19 to 25 decreased from 34% in 2010 to 21% in the first quarter of 2014, a decline of nearly 4 million individuals.
For the study, researchers from the American Cancer Society assessed whether expanded health coverage among young women in the U.S. resulted in more early-stage cervical cancer diagnoses.
The researchers analyzed data from a hospital-based registry, called the National Cancer Data Base, which includes information on nearly 70% of cancer diagnoses in the U.S. The researchers used the data to compare diagnoses for women with cervical cancer ages 21 to 25 with diagnoses for women with cervical cancer ages 26 to 34 before and after the ACA provision took effect.
The study found that the percentage of early-stage diagnoses among women ages 21 to 25 with cervical cancer increased from 71% between 2007 and 2009 to 79% between 2011 and 2012. Meanwhile, there was no statistically significant change in the percentage of early-stage diagnoses among women age 26 to 34 with cervical cancer over the same time frame. Among that group, the percentage of early-stage diagnoses declined from 73% between 2007 and 2009 to 71% between 2011 and 2012.
The researchers also found that the increase in early-stage diagnoses among the younger age group was heightened when they looked at the data by year. For example, the percentage of early-stage cervical cancer diagnoses among the younger group increased from 68% in 2009 to 84% in 2011.
Study co-author Ahmedin Jemal said there was decrease in early-stage diagnoses among the younger group in 2012, declining to 72%, but he noted that the decrease is common when there are more screenings, as many early-stage cases already have been detected.
According to the Times, the study did not seek to demonstrate that the increase in early-stage diagnoses was a direct result of the ACA. However, the researchers determined that the law has some effect on the increase in early-stage diagnoses based on the size of the database and the substantial increase in the proportion of young women with health insurance coverage (Tavernise, New York Times, 11/24).
The researchers also found that women with cervical cancer diagnoses increasingly are receiving fertility-sparing treatment, a trend they said likely was not linked to the ACA. Study co-author Xuesong Han noted that the increase was already taking place between 2007 and 2009, and she attributed the continuing increase to advances in cervical cancer treatment and the increased rate of early-stage diagnoses.
Han said, "This suggests the dependent coverage expansion has helped young women access preventive services." Han also noted that Pap tests under the ACA do not have copays, which she said "removes another potential barrier" (Norton, HealthDay/U.S. News & World Report, 11/24).
Jemal said, "It's a very remarkable finding, actually," adding, "You see the effect of the A.C.A. on the cancer outcomes" (New York Times, 11/24).
Meanwhile, Brendan Saloner, a researcher at Johns Hopkins Bloomberg School of Public Health who led a similar study, said, "It's always possible that trends other than the ACA (Affordable Care Act) provision influenced this" (HealthDay/U.S. News & World Report, 11/24).