Study Finds Decrease in Racial Disparity, Increase in Survival Rates for Metastatic Breast Cancer

Medicaid expansion implementation was associated with a decrease in the number of uninsured patients from 6.7% pre-expansion to 3.6% post-expansion.

Thanks in part to the expansion of Medicaid, a new study has found decreasing racial disparities and increasing survival rates among patients with metastatic breast cancer.

According to a study from Susan G. Komen Scholars, research indicates that patients diagnosed with de novo stage 4 breast cancer had improved survival rates and decreased mortality rates when they had access to care.

This marks the first study that demonstrates not only the improved outcomes due to Medicaid expansion, but also a decrease in the rates of racial disparities. Medicaid expansion was associated with an improved survival and decreased 2-year mortality disparity in the post-expansion period compared to the pre-expansion period, according to the investigators.

“Patients who are uninsured and belong to racial and ethnic minority groups or have low socioeconomic status have suboptimal access to health care that is likely affecting outcomes,” said Victoria Wolodzko Smart, senior vice president of mission at Susan G. Komen, in a press release. “The study findings are proof points on the benefits of Medicaid expansion and that is why Susan G. Komen continues to support policy efforts to expand Medicaid eligibility in every state across the country.”

In the study, investigators compared overall survival and 2-year mortality among 9322 white and non-white patients from 19 states. Of the study participants, 5077 were diagnosed before Medicaid expansion and 4245 were diagnosed after Medicaid was expanded.

The racial and ethnic minority group included 2545 patients, of whom 500 (5.4%) were Hispanic, 1515 (16.3%) were non-Hispanic Black, and 530 (5.7%) were non-Hispanic other. The non-Hispanic other group included 25 American Indian or Alaskan Native patients, 357 Asian or Pacific Islander patients, and 148 unknown patients.

The cohort was selected on a uniform date of Medicaid expansion between January 1, 2010, and December 31, 2016, with de novo stage 4 breast cancer. Patients’ ages ranged from 40 to 60 years because patients become eligible for Medicare at 65 years of age.

According to the study findings, Medicaid expansion implementation was associated with a decrease in the number of uninsured patients (6.7% pre-expansion versus 3.6% post-expansion). The overall 2-year mortality rate for the entire study population was 29.4%, which gradually decreased from 33.6% in 2010 to 25.6% in 2015.

Among white patients, the 2-year adjusted mortality rates decreased from 40.6% in the pre-expansion period to 36.3% in the post-expansion period. Among patients of racial and ethnic minority groups, the 2-year mortality rate decreased from 45.6% to 35.8%.

“This study makes clear that policies that increase access to health care reduce disparities in people with metastatic breast cancer,” said study author Sharon Giordano, MD, MPH, FASCO, in the press release. “There are no cures for metastatic breast cancer and improved survival is critical for people living with the disease regardless of their socioeconomic status or ethnicity.”

REFERENCE

Study Finds Decrease In Racial Disparity and Increase in Survival Rates in Metastatic Breast Cancer Patients Due to Medicaid Expansion. News release. Susan G. Komen; April 8, 2022. Accessed April 18, 2022. https://blog.komen.org/news/medicaid-expansion-and-mbc-outcomes/