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New analyses by scientists from the American Cancer Society suggest states’ Medicaid policies, lifelines to healthcare for low-income individuals and families in the U.S., are critical to survival after cancer diagnosis. These analyses are part of a study published today in JCO: Oncology Practice.

Researchers at the American Cancer Society, led by Jingxuan Zhao, MPH, looked at more than 1.4 million adults newly diagnosed with 19 common cancers during 2010-2013 identified from the National Cancer Database, with up to 8 years of follow-up.

Among patients with newly diagnosed cancer, living in states with lower Medicaid income eligibility limits was associated with worse survival for most cancers in both early and late stages, compared to living in states with higher Medicaid income eligibility limits.

“Our findings that lower historic state Medicaid income eligibility limits were associated with worse long-term survival within stage suggest that increasing Medicaid income eligibility could be an important policy lever for improving survival after cancer diagnosis,” said Jingxuan Zhao, MPH, Senior Associate Scientist at the American Cancer Society.

The researchers suggested there are a few reasons why the association between state Medicaid income eligibility limits and stage-specific survival among cancer patients exists. First, having health insurance may improve access to timely, guideline-concordant care and facilitate completion of treatment. For cancers with effective treatments, access to cancer treatment is strongly associated with survival. As advanced therapies, such as immunotherapy and targeted therapy, have been introduced in recent years, access to these therapies may also contribute to better survival outcomes.

Second, having health insurance is also associated with access to cancer surveillance and general and specialized health care during survivorship. This is especially relevant in this study because it evaluated 8-year all-cause mortality and found consistent patterns across most cancer sites.

The study consistently found the association of lower historic state Medicaid income eligibility limits with worse stage-specific survival and findings suggest that indicates state Medicaid policies may play an important role in improving health outcomes for patients diagnosed with cancer that go beyond screening and early detection and potentially include access to cancer treatment and survivorship care.

Reference:Jingxuan Zhao, MPH ; Xuesong Han, PhD; Leticia Nogueira, MPH, PhD; Noorie Hyun, PhD; Ahmedin Jemal, DVM, PhD; and K. Robin Yabroff, PhD, MBA. Association of State Medicaid Income Eligibility Limits and Long-Term Survival After Cancer Diagnosis in the United States. JCO: Oncology Practice. (https://ascopubs.org/doi/full/10.1200/OP.21.00631).