Affordable Care Act May Have Contributed to Early Detection of Cervical Cancer

Kevin Ault, MD, FACOG

Kevin Ault, MD, FACOG

Implementation of the Affordable Care Act (ACA) may have helped increase the number of women whose cases of cervical cancers were found and treated early, according to a study¹published inJAMA.The study found that after the 2010 act, 79% of cervical cancer cases in women between the ages of 21 to 25 were found at stage I or II, whereas, before the initiative, 71% of cases were found through early detection.

Since the introduction of the ACA, the number of women eligible for coverage of treatments for cervical cancer has grown, rising from 26% before the initiative to about 39% after the coverage change.

“When cervical cancer is caught early, doctors can treat it with relatively small surgeries that leave the uterus intact, so that women can still have children,” said Xuesong Han, PhD, director of surveillance and health services research at the American Cancer Society, in a statement.

According to the American Cancer Society, 91% of women with early cervical cancer survive at least 5 years whereas only 16% of women with advanced cervical cancer live that long.

Kevin Ault, MD, FACOG, a professor at the University of Kansas Medical Center, said in aUSA Todayarticle,²that cervical cancer is nearly 100% preventable. "Regular screenings with a doctor to help detect and remove precancerous lesions, as well as the human papillomavirus vaccine gives women the opportunity to protect themselves from acquiring the disease," he said.

While The American College of Obstetricians and Gynecologists advises women to begin regular screenings with a physician by the age of 21, administering the vaccine begins much earlier in young women. The Centers for Disease Control and Prevention believes the HPV vaccine should be given to girls aged 11 through 12, because it is most effective before the individual becomes sexually active.²

The use of early detection and preventive care has sharply decreased the number of cervical cancer cases over the past several decades. Ault said that the disease was the leading cause of cancer-related death in women during the 1930s and 1940s; however, the American Cancer Society reports now that 12,900 Americans are affected by the disease.

The study warned, however, that there is no true way to verify the cause and effect relationship between the implantation of the ACA and increase in early detection cases. However, when compared with the number of early cases found in women ages 26 to 34, who were not eligible for the 2010 insurance expansion, researchers found no significant change.

The study also asserted that women with coverage were simply more likely to find cases of cervical cancer early, where nearly 78% of women with private insurance found and treated the disease early. In comparison, only 67% of women without insurance and 65% of women with Medicaid coverage caught the cancer early.

References:

1. Robbins, AS, Han, X, Ward, EM, et al. Association between the affordable care act dependent coverage expansion and cervical cancer stage and treatment in young women.JAMA.2015;314(20):2189-2191.

2. Szabo L. Early detection of cervical cancer increased after ACA expanded coverage. USA TODAY. 2015. Available at: http://www.usatoday.com/story/news/2015/11/24/early-detection-cervical-cancer-increased-after-aca-expanded-coverage/76273190/. Accessed December 9, 2015.