Affordable Care Act Improved Care of Colorectal Cancer in Young Adults

The Affordable Care Act (ACA) has led to better treatment for young adults diagnosed with colorectal cancer, according to a study from the American Cancer Society. A provision in the ACA allows young adults up to age 26 to be covered under their parents’ private health care insurance. The study, published December 19, 2019 in the Journal of the National Cancer Institute, says the provision helped these young adults get diagnosed earlier and start some treatments sooner.

The researchers used the National Cancer Database to look at data from more than 10,000 young adults diagnosed with colorectal cancer between 2007 and 2013. They compared outcomes for those diagnosed before the ACA took effect in 2010 with those diagnosed after it took effect. They looked at 2 age groups: 19 to 25-year-old patients, who were eligible to be on their parents’ insurance, and 27 to 34-year-old patients, who had “aged out” of their parents’ health insurance.

They found eligible patients got better care after the ACA was enacted:

• The percent diagnosed with early stage cancer increased from 12.8% before the ACA to 27.8% after the ACA went into effect. Early stage cancers are generally easier to treat than later stage cancers.
• Those who had surgery for stage IIB to IIIC colorectal cancer were 34% more likely after ACA to receive adjuvant, or additional chemotherapy, which is widely considered to be the standard of care.
• Among those who received adjuvant chemotherapy, the average time from surgery to chemotherapy was 7 days shorter: from 57.4 days before ACA to 50.4 days after ACA.

At the same time, there was no significant change in care after the ACA took effect for the patients not eligible to be on their parents’ insurance.

The people in the study were too young for routine colorectal cancer screening. The authors write the improvements in care are most likely due to better access to health care that helped them get symptoms checked out earlier.