Incidence of early-stage breast CA, CRC up with ACA adoption

(HealthDay)—After adoption of the Affordable Care Act (ACA), there was an increase in the incidence of early-stage breast and colorectal cancer, according to a research letter published online Nov. 2 in JAMA Oncology.

Maxine Sun, Ph.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues compared age-adjusted incidence rates of early-stage breast, colorectal, and cervical cancer in the first nine months of 2013 (pre-ACA) and the last nine months of 2014 (post-ACA). The authors computed incidence rate ratios (IRRs) to assess for change between pre- and post-ACA.

The researchers found that the incidence of early-stage breast cancer increased from 55.5 to 56.9 cases per 100,000 person-years from pre- to post-ACA, with an IRR of 1.025. A significantly greater difference in IRRs was seen for early stages versus locally advanced/metastatic stages. For early-stage colorectal cancer, the incidence increased from 13.5 to 15.3 cases per 100,000 person-years, with a pre- to post-ACA IRR of 1.132. A significantly greater change in incidence rates was seen for early versus locally advanced/metastatic stages. This pattern was not observed with cervical cancer.

"We found that incidence of early-stage breast and colorectal cancer increased after the adoption of the ACA, whereas it did not vary for late-stage cancer," the authors write. "Although screening itself was not assessed, the trend is consistent with modest but immediate increases in colorectal and breast cancer screening following the ACA."

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