Comparing breast cancer outcomes between medicaid and the Ohio breast and cervical cancer early detection program

Siran M. Koroukian, Paul M. Bakaki, Mark Schluchter, Cynthia Owusu, Gregory S. Cooper, Sue Flocke

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: To compare outcomes between women enrolling in Medicaid after being diagnosed with breast cancer and those referred to Medicaid through the Ohio Breast and Cervical Cancer Early Detection Program (BCCEDP). Methods: Using linked data from the 2002 to 2008 Ohio Cancer Incidence Surveillance System, Medicaid, the BCCEDP database, and Ohio death certificates (through 2010), we identified women 40 to 64 years of age diagnosed with incident invasive breast cancer during the study years and enrolled in Medicaid 3 months before or after cancer diagnosis. We compared the following outcomes across BCCEDP one-time and repeat participants and nonparticipants: (1) cancer stage at diagnosis, (2) treatment delays, (3) receipt of standard treatment, and (4) survival. We conducted multivariable logistic regression and survival analysis to examine the association between BCCEDP participation and the outcomes of interest, controlling for potential confounders. Results: We identified 427 and 654 BCCEDP participants and nonparticipants, respectively; 28.5% of BCCEDP women were repeat participants. Compared with nonparticipants, BCCEDP one-time and repeat participants were significantly less likely to be diagnosed with advanced-stage cancer (one-time: adjusted odds ratio [AOR], 0.64; 95% CI, 0.49 to 0.85; repeat: AOR, 0.34; 95% CI, 0.23 to 0.52), or experience delays in treatment initiation (one-time: adjusted hazard ratio [AHR], 1.29; 95% CI, 1.09 to 1.51; repeat: AHR, 1.38; 95% CI, 1.11 to 1.72). In addition, although we observed no difference in receipt of standard cancer treatment, BCCEDP participants experienced cancer-specific and overall survival benefits. Conclusion: Compared with nonparticipants, BCCEDP participants experienced earlier breast cancer stage at diagnosis, shorter time to treatment initiation, and survival benefits.

Original languageEnglish (US)
Pages (from-to)478-485
Number of pages8
JournalJournal of oncology practice
Volume11
Issue number6
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Medicaid
Uterine Cervical Neoplasms
Breast Neoplasms
Neoplasms
Survival
Odds Ratio
Therapeutics
Death Certificates
Survival Analysis
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy

Cite this

Comparing breast cancer outcomes between medicaid and the Ohio breast and cervical cancer early detection program. / Koroukian, Siran M.; Bakaki, Paul M.; Schluchter, Mark; Owusu, Cynthia; Cooper, Gregory S.; Flocke, Sue.

In: Journal of oncology practice, Vol. 11, No. 6, 01.01.2015, p. 478-485.

Research output: Contribution to journalArticle

Koroukian, Siran M. ; Bakaki, Paul M. ; Schluchter, Mark ; Owusu, Cynthia ; Cooper, Gregory S. ; Flocke, Sue. / Comparing breast cancer outcomes between medicaid and the Ohio breast and cervical cancer early detection program. In: Journal of oncology practice. 2015 ; Vol. 11, No. 6. pp. 478-485.
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abstract = "Purpose: To compare outcomes between women enrolling in Medicaid after being diagnosed with breast cancer and those referred to Medicaid through the Ohio Breast and Cervical Cancer Early Detection Program (BCCEDP). Methods: Using linked data from the 2002 to 2008 Ohio Cancer Incidence Surveillance System, Medicaid, the BCCEDP database, and Ohio death certificates (through 2010), we identified women 40 to 64 years of age diagnosed with incident invasive breast cancer during the study years and enrolled in Medicaid 3 months before or after cancer diagnosis. We compared the following outcomes across BCCEDP one-time and repeat participants and nonparticipants: (1) cancer stage at diagnosis, (2) treatment delays, (3) receipt of standard treatment, and (4) survival. We conducted multivariable logistic regression and survival analysis to examine the association between BCCEDP participation and the outcomes of interest, controlling for potential confounders. Results: We identified 427 and 654 BCCEDP participants and nonparticipants, respectively; 28.5{\%} of BCCEDP women were repeat participants. Compared with nonparticipants, BCCEDP one-time and repeat participants were significantly less likely to be diagnosed with advanced-stage cancer (one-time: adjusted odds ratio [AOR], 0.64; 95{\%} CI, 0.49 to 0.85; repeat: AOR, 0.34; 95{\%} CI, 0.23 to 0.52), or experience delays in treatment initiation (one-time: adjusted hazard ratio [AHR], 1.29; 95{\%} CI, 1.09 to 1.51; repeat: AHR, 1.38; 95{\%} CI, 1.11 to 1.72). In addition, although we observed no difference in receipt of standard cancer treatment, BCCEDP participants experienced cancer-specific and overall survival benefits. Conclusion: Compared with nonparticipants, BCCEDP participants experienced earlier breast cancer stage at diagnosis, shorter time to treatment initiation, and survival benefits.",
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