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Medicaid expansion and thyroid cancer stage at presentation: A comparative study of two US states
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Medicaid expansion and thyroid cancer stage at presentation: A comparative study of two US states
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Journal Article
Medicaid expansion and thyroid cancer stage at presentation: A comparative study of two US states
2025
Overview
The Affordable Care Act (ACA) enabled states to expand Medicaid eligibility, extending coverage to millions, particularly in California. While Medicaid expansion has been linked to earlier diagnoses in several cancers, its impact on thyroid cancer—a slow-growing malignancy lacking formal screening—remains unclear.
To assess whether Medicaid expansion influenced thyroid cancer stage at presentation.
A retrospective cohort study using SEER data (2009–2020) compared adults aged 18–64 diagnosed with thyroid cancer in California (expansion) and Texas (non-expansion). Difference-in-differences logistic regression evaluated stage changes pre- (2009–2013) and post- (2016–2020) expansion, excluding a 2014–2015 washout period.
Among 63,073 patients, no significant difference in stage at diagnosis was observed between states. Estimates for localized, regional, and distant disease changes ranged from −1.3 % to 1.1 % (all 95 % CIs included zero).
Medicaid expansion was not associated with a significant shift in thyroid cancer stage at presentation.
•Medicaid expansion had limited impact on thyroid cancer stage at diagnosis.•Most thyroid cancers are detected at an early stage.•Medicaid expansion had little effect on when thyroid cancer is diagnosed, likely due to its slow growth and lack of screening guidelines.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Adult
/ Affordable care act policy impacts
/ Age
/ Cancer
/ Disease
/ Female
/ Humans
/ Male
/ Medicaid
/ Medicaid - statistics & numerical data
/ Patient Protection & Affordable Care Act 2010-US
/ Patient Protection and Affordable Care Act
/ Patients
/ Poverty
/ Thyroid
/ Thyroid Neoplasms - diagnosis
/ Thyroid Neoplasms - epidemiology
