Medicaid expansion was associated with a decrease in the incidence of distant stage cancer and cancer death, according to a study published in the Journal of the National Cancer Institute.

Researchers looked at nationwide, state-level cancer data from 2001-2019 for people aged 20 to 64 years. The researchers estimated changes in distant stage cancer incidence and death by comparing rates prior to Medicaid expansion in 2014 and after the expansion. 

During 2001-2019, there were 2,796,549 new distant stage cancer diagnoses and 3,234,810 cancer deaths.

For all cancer sites combined, there was a post-expansion decrease in the incidence of distant stage cancer (odds ratio [OR], 0.972; 95% CI, 0.950-0.994; P =.015) and cancer death (OR, 0.975; 95% CI, 0.951-1.000; P =.049) in states with Medicaid expansion relative to states without expansion. 

Continue Reading

These decreases translated to 2591 averted distant stage cancer diagnoses and 1616 averted cancer deaths between 2015 and 2019. According to the researchers, much of the decrease in cancer mortality was explained by the reduction in distant stage cancer incidence. 

“In our study, approximately 60% of cancer mortality rate changes overall were explained by reductions in distant stage cancer incidence,” the researchers wrote. “Other uncaptured mediators may also be driving mortality benefits for expansion states, including timely initiation of therapy, higher cancer therapy receipt and completion rates, higher rates of guideline-concordant care, better follow-up care, and lower rates of financial toxicity, some of which have been previously associated with Medicaid expansion.”

There were no significant differences in distant stage diagnoses by specific cancer sites, and the magnitude of decreases in cancer death was similar across most cancer sites.

“Our findings are especially relevant as health care policies continue to have an important place in the current political climate in the United States, including active consideration of Medicaid income eligibility expansion measures in some of the 10 states that have not adopted Medicaid expansion,” the researchers wrote.


Barnes JM, Johnson KJ, Osazuwa-Peters N, et al. Changes in cancer mortality after Medicaid expansion and the role of stage at diagnosis. J Natl Cancer Inst. Published online May 18, 2023. doi:10.1093/jnci/djad094

This article originally appeared on Cancer Therapy Advisor