Medicaid expansion associated with smaller declines in early-stage cancer diagnoses during the COVID-19 pandemic in the US
Report adds to growing evidence of the benefits of Medicaid expansion for cancer diagnoses and patient outcomes.
The COVID-19 pandemic disrupted health care, including cancer screening and diagnosis, especially for medically underserved populations, leading to substantial underdiagnosis of early-stage cancers in 2020. In a new study, released Oct. 20, scientists found that Medicaid expansion was associated with smaller declines in early-stage cancer detection among adults during the pandemic. The study was published in the Journal of the National Cancer Institute (JNCI).
“Many people experienced job disruptions and financial instability during the pandemic, which led to cost barriers to timely care," said Dr. Xuesong Han, scientific director, health services research at ACS, and lead author of the study. “This data suggests a protective effect of Medicaid expansion on cancer early diagnosis during the public health emergency."
“Our findings can inform policymakers and the public in the 10 states that have yet to expand Medicaid eligibility," Dr. Han added. “The findings also provide critical information for policymakers and the public in all states about the public health implications of upcoming large federal cuts to Medicaid programs and expected loss of insurance coverage for more than 10 million adults."
“This research adds to the mountain of existing proof that Medicaid expansion saves lives from cancer by reducing the number of people who are uninsured," said Lisa A. Lacasse, president of ACS CAN. “ACS CAN has long advocated for Medicaid expansion, and our work continues as states begin to contemplate how to implement the drastic changes from this summer's budget reconciliation law. These recent changes made by Congress to cut Medicaid will undo decades of progress in the fight against cancer. Increasing and protecting existing access to this critical program must be a priority nationwide if we are to end cancer as we know it, for everyone."
Other ACS researchers contributing to the study include Nova Yang, MSPH, Dr. Qinjin Fan, Dr. Leticia Nogueira, Dr. Ahmedin Jemal, and senior author Dr. Robin Yabroff.
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Key research presented by ACS experts at 2025 ASCO Quality Care Symposium
ACS abstracts were highlighted during presentations at this year's event.
Scientists from ACS presented research studies at the 2025 Annual Meeting of the American Society of Clinical Oncology (ASCO) Quality Care Symposium (QCS), Oct. 10 – 11, in Chicago, IL. ASCO QCS offers research and education that encompasses the needs and viewpoints of multiple disciplines and various practice settings, attracting oncology professionals from around the world. This year's program featured studies complementing the meeting's theme: “Partners in Care: Building Bridges Through Shared Decisions."
- Disparities in palliative care receipt among young adults newly diagnosed with advanced cancers, presented by Kewei (Sylvia) Shi, MPH. Read details about the study in the ACS press room.
- Health-related social needs, biological aging, and long-term mortality risk among a nationally representative cohort of cancer survivors, presented by Dr. Xuesong Han. Read details about the study in the ACS press room.
- Trends in survival disparity following breast cancer diagnosis by health insurance coverage and race in the US, presented by Dr. Jingxuan Zhao. Read details about the study in the ACS press room.
- Smoking status and productivity loss among working-age cancer survivors in the United States, presented by Dr. Zhiyuan (Jason) Zheng. Read details about the study in the ACS press room.
- Patients with rare cancers: Diagnosis and treatment patterns in the US, presented by Nova Yang, MSPH. Read details about the study in the ACS press room.
- Federal housing assistance and treatment receipt for non-small cell lung cancer patients in the US, presented by Dr. Qinjin Fan. Read details about the study in the ACS press room.
Prostate cancer survivors who follow healthy lifestyle guidelines live longer
Researchers stress the importance of following ACS Nutrition and Physical Activity Guidelines for cancer survivors.
A new study announced Sept. 26 reports that men diagnosed with non-metastatic prostate cancer who adopted the ACS Nutrition and Physical Activity Guideline for Cancer Survivors after diagnosis live longer. Over 14 years of follow-up, men with the highest adherence to the guideline were 23% less likely to die of any cause and 25% less likely to die from cardiovascular disease compared with those with the lowest adherence. The ACS guideline recommends avoiding obesity, engaging in regular physical activity, following a healthy diet, and limiting alcohol. The study was published in the Journal of the American Medical Association (JAMA) Network Open.
“Even men who were not following the guideline before their prostate cancer diagnosis, but improved afterward, experienced lower mortality compared with men who maintained low adherence, " said Dr. Valeria Elahy, post-doctoral fellow in cancer epidemiology, prevention, and survivorship at the ACS and lead author of the study. “It's never too late to benefit from adopting healthier lifestyle behaviors."
“Cardiovascular disease is the most common non-cancer cause of death for this group of men," said Dr. Ying Wang, senior principal scientist, epidemiology research, and senior author of the study. “Our results suggest that healthy lifestyle behaviors can significantly reduce the risk of cardiovascular disease mortality. Future research should evaluate how best to support survivors in adopting and sustaining these behaviors."
Other ACS researchers contributing to the study include Christina Newton, MSPH, Dr. Majorie McCullough, Dr. Lauren Teras, Dr. Clara Bodelon, Dr. Erika Rees-Punia, Dr. Caroline Um, Dr. Laura Makaroff, and Dr. Alpa Patel.
Study finds cancer survival rates lower in rural areas, aligned with disparities in receipt of care
Researchers stress the need to increase access to cancer care for historically marginalized populations to help mitigate disparities.
A new study released Sept. 24 shows that the overall five-year cancer survival rates for each stage of cancer (localized, regional, distant) were lower in non-metropolitan areas for Black and White individuals in the United States. The results also find that survival rates are lower for Black persons compared to White persons across various cancer types and in several stages and categories of urbanicity, especially for breast and colorectal cancers. Urbanicity was defined as the degree to which an area is considered urban or rural, ranging from highly populated metropolitan areas to rural settings. Lower cancer survival generally aligned with lower receipt of cancer treatment. The study was published in Cancer, an international, interdisciplinary journal of the American Cancer Society.
“Lower survival rates for cancers with the same stage at diagnosis in non-metropolitan areas largely reflect disparities in receipt of quality cancer care due to inequities in social determinants of health, including lack of insurance coverage," said Dr. Farhad Islami, senior scientific director, cancer disparity research at the American Cancer Society and lead author of the study. “This needs to change. Increasing access to cancer care to these historically marginalized populations is critically needed to mitigate disparities."
“More research concerning interventions to mitigate disparities in cancer treatment and care and the contributing social factors is needed," Islami added.
“Where someone lives shouldn't determine if they live," said Lisa A. Lacasse, president of ACS CAN. “This study provides further evidence of how important access to timely, high-quality, affordable health care is to having better health outcomes and reducing cancer disparities. We can't afford to have new or existing barriers to accessing cancer prevention, screening, or treatment services. We urge Congress to support funding increases for cancer prevention and early detection programs at the Centers for Disease Control and Prevention and extend the health care tax credits before time runs out. Our ability to reduce the cancer burden for everyone relies on this."
Other ACS researchers involved in this study include Dr. Daniel Wiese, Elizabeth Schafer, MPH, Dr. Hyuna Sung, and senior author Dr. Ahmedin Jemal.
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