ASPPH logo


Member Research & Reports

Member Research & Reports

Kentucky: ACA Medicaid Expansion Increases Colon Cancer Screenings, Survival

A new study from the University of Kentucky (UK) shows a direct link between the adoption of the Affordable Care Act (ACA) Medicaid expansion and the impact of colon cancer on Kentuckians. With authors from the Markey Cancer Center, UK College of Medicine, and the University of Kentucky College of Public Health departments of biostatistics and epidemiology, “Impact of the Affordable Care Act on Colorectal Cancer Screening, Incidence, and Survival in Kentucky” appears in the Journal of the American College of Surgeons.

In the study, researchers looked at statistics for screening, incidence and outcomes of colon cancer from the Kentucky Hospital Discharge Database in the Kentucky Cabinet for Health and Family Services and the Kentucky Cancer Registry. Pre-ACA Medicaid expansion (2011-2013) – where approximately 14 percent of Kentuckians were uninsured – was compared to post-ACA Medicaid Expansion (2014-16), where that number dropped to about six percent.

Results showed a substantial increase – 230 percent – in the number of Medicaid patients who received colon cancer screening post-expansion compared to Medicaid patients who received screening prior to the expansion. This was particularly prominent in the Appalachian region of the state, where 43 percent more patients received screening post-expansion. For Medicaid patients in Appalachia, data also showed a 9.3 percent increase in early stage diagnosis of colon cancer – when the disease is more easily treated –  and a 27 percent decrease in risk of death.

Kentucky has one of the highest rates of both colon cancer incidence (1st) and mortality (5th) in the nation, although the state has seen great improvement in the past two decades due to massive public health efforts.