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Medical Rounds

Health Policy: Catching Gynecologic Cancers Earlier

The gains in insurance coverage with the Patient Protection and Affordable Care Act (ACA) have already translated into improved health for young women with gynecologic cancers, who are getting diagnosed at earlier stages of their disease because of ACA benefits. That’s the conclusion of a new study by Johns Hopkins researchers, who looked at nationwide trends in gynecologic cancer diagnosis in a large population of women before and after the ACA’s implementation in 2010.

“We were pleased to see that there was a significant improvement in capturing more women’s cancers early,” says gyn-ob and senior author Amanda Nickles Fader. “It can take decades to observe changes in population-based health trends, so to see differences this soon is promising.” Women of all ages are at risk for gynecologic cancers, which include cervical, ovarian, uterine, vaginal and vulvar cancers. However, rates of these cancers—linked to both obesity and infection with HPV—are rising in young women. Each year in the U.S., about 2,000 women under age 26 are diagnosed with a gynecologic cancer. In this population, early diagnosis is critical to treatment success and the ability to maintain fertility after treatment, Nickles Fader notes.

Nickles Fader and her team credit the ACA for the improvement in early diagnosis because one of the key parts of the health care law was the dependent coverage mandate, which allows young adults to stay on their parents’ health insurance through age 26. Nationwide, before the ACA, one in three women ages 19 to 26 was uninsured; since the new health care legislation went into effect, less than one in five of these women is uninsured.

“We know if these women are identified early and treated early, they are much more likely to live longer and have their cancer go into remission,” says gyn-ob resident Anna Jo Bodurtha Smith, first author of the new paper, which appeared in Obstetrics & Gynecology.