Expanded Medicaid Affects Breast Cancer Screening Rates

Expanded Medicaid in some states allows more low-income women to undergo breast cancer screening, according to a study presented at the annual meeting of the Radiological Society of North America (RSNA).

Researchers from St. John Providence Hospital in Southfield, MI, sought to determine if increased access to health insurance in the early expansion states (California, Connecticut, Minnesota, New Jersey and Washington, as well as Washington, D.C.), improved breast cancer screening adherence among lower income women. These states had implemented the programs in 2011.

"While increased use of screening mammography has significantly contributed to improved detection of breast cancer, substantial disparities in breast cancer screening exist among populations in the country," lead author Soudabeh Fazeli Dehkordy, MD, MPH, said in a release. "We sought to determine whether increasing access to health insurance through Medicaid expansion has resulted in improved breast cancer screening adherence."[[{"type":"media","view_mode":"media_crop","fid":"43719","attributes":{"alt":"Soudabeh Fazeli Dehkordy, MD, MPH","class":"media-image media-image-right","id":"media_crop_9835820078116","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4819","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 194px; width: 170px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"Soudabeh Fazeli Dehkordy, MD, MPH. ©RSNA 2015.","typeof":"foaf:Image"}}]]

The researchers used data obtained from the 2008 and 2012 Behavioral Risk Factor Surveillance System and self-reported data to determine adherence by these states and compared these to nonexpansion states.

The results showed that in 2008, screening mammography adherence was 78.5% among women aged 40 to 70 in the early expansion states, compared with 76.3% in nonexpansion states. However, the rates dropped in both sets of states by 2012, with 77% of women undergoing screening in the expansion states and 73.5% in the nonexpansion states. The same decline was seen among lower income women. However, despite the overall decline, women in the expansion states were still 25% more likely to be screened than in the nonexpansion states, the researchers noted.

"Understanding the impact of Medicaid expansion on breast cancer screening rates in early expander states can provide valuable insights that can be very useful to both state and federal policymakers when considering key health policy," Dehkordy said in the release.

Currently, 23 states have opted to expand Medicaid coverage. Six others are implementing alternatives. The remaining states elected not to implement the expansion program or are still in the process of considering it.

"Adoption of Medicaid expansion by more states can result in considerable improvement of disparities in breast cancer screening, leading to better health outcomes for all women across the United States," Dehkordy concluded.