{"doi":"10.1093/jncics/pkad067","title":"Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer","abstract":"Female breast cancer is a common cancer in young adults, an age group with the highest uninsured rate. Among 51 675 young adult women (ages 18-39 years) diagnosed with breast cancer between 2011 and 2018 in the National Cancer Database, we estimated changes in guideline-concordant treatment receipt, treatment timeliness, and survival associated with the Affordable Care Act Medicaid expansion. Of young adults with stage I-III estrogen receptor-positive or progesterone receptor-positive breast cancer, Medicaid expansion was associated with a net increase of 2.42 percentage points (95% confidence interval [CI] = 0.56 to 4.28 percentage points) in the percentage receiving endocrine therapy. Among all young adults with stage I-III breast cancer, Medicaid expansion was associated with a net reduction of 1.65 percentage points (95% CI = 0.08 to 3.22 percentage points) in treatment delays defined as treatment initiation of at least 60 days after diagnosis and a net increase of 1.00 percentage points (95% CI = 0.21 to 1.79 percentage points) in 2-year overall survival. Our study provides evidence of benefit in cancer care and outcomes from Medicaid expansion among the young adult population.","journal":"JNCI Cancer Spectrum","year":2023,"id":341624,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":15,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9338,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":869794,"name":"Kewei Sylvia Shi","orcid":"0000-0002-0024-4916","position":1,"is_corresponding":false},{"id":274813,"name":"Kathryn J. Ruddy","orcid":"0000-0001-6298-332X","position":2,"is_corresponding":false},{"id":225095,"name":"Jingxuan Zhao","orcid":"0000-0002-2733-2000","position":3,"is_corresponding":false},{"id":431933,"name":"Ann C. Mertens","orcid":"0000-0003-0989-0962","position":4,"is_corresponding":false},{"id":225096,"name":"K. Robin Yabroff","orcid":"0000-0003-0644-5572","position":5,"is_corresponding":false},{"id":282785,"name":"Sharon M. Castellino","orcid":"0000-0001-8367-2002","position":6,"is_corresponding":false},{"id":259661,"name":"Xuesong Han","orcid":"0000-0001-7159-7949","position":7,"is_corresponding":false},{"id":404217,"name":"Xu Ji","orcid":"0000-0003-3025-3984","position":0,"is_corresponding":true}],"reference_count":14,"raw_metadata":null,"created_at":"2026-07-19T01:11:08.077724Z","pmid":"37707583","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}