Medicaid Expansion and Overall Survival of Lower Gastrointestinal Cancer Patients After Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy
2025

Impact of Medicaid Expansion on Survival in Lower Gastrointestinal Cancer Patients

Sample size: 1001 publication 10 minutes Evidence: high

Author Information

Author(s): Ramalingam Kirithiga MD, Ji Liang MPH, O’Leary Michael P. MD, Lum Sharon S. MD, MBA, Caba Molina David MD, MS, MPH

Primary Institution: Loma Linda University

Hypothesis

Medicaid expansion is associated with decreased all-cause mortality of lower gastrointestinal cancer patients following CRS+HIPEC.

Conclusion

Improved access to healthcare through Medicaid expansion was associated with increased survival rates of lower gastrointestinal cancer patients who undergo CRS+HIPEC.

Supporting Evidence

  • Patients in Medicaid expansion states experienced a 4% increase in annual survival.
  • Patients in non-expansion states had a 1% decrease in annual survival.
  • Grade and Medicaid expansion status were independently associated with overall survival.

Takeaway

This study found that patients in states that expanded Medicaid had better chances of living longer after surgery for cancer in their lower intestines.

Methodology

Data from the National Cancer Database (2010–2019) was analyzed using a multivariable Cox regression model.

Potential Biases

Incomplete data and loss of follow-up could introduce bias.

Limitations

The study relies on overall survival as the primary outcome measure and may not be generalizable to patients treated outside Commission on Cancer-accredited programs.

Participant Demographics

75.8% of patients were younger than 65 years, predominantly non-Hispanic White (81.7%).

Statistical Information

P-Value

p<0.001

Confidence Interval

0.52–0.97

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1245/s10434-024-16446-8

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication