Affordable Care Act Increased Access to Breast Cancer Care

The number of Hispanic breast cancer patients getting care and participating in a clinical trial in a cancer center in California increased, a study found.

In California, the Affordable Care Act (ACA) may have significantly increased the number of Hispanic breast cancer patients receiving care at an NCI-designated cancer center as well as participation in a clinical trial, according to a study presented at the AACR Cancer Health Disparities Conference in September 2016.

“From both scientific and ethical standpoints, it is critical to have diverse patient populations represented in clinical trials,” said Chloe Lalonde, who was a clinical research coordinator at the University of California San Diego Moores Cancer Center at the time of this study, and is now a medical student at the Emory University School of Medicine in Atlanta, Georgia. “Therefore, it is important to examine the effects of health care policies and practices to identify both barriers and facilitators that patients encounter in seeking and/or being offered participation in clinical trials.”

Following the implementation of the ACA – or “Obamacare” – in California, Lalonde and colleagues observed a higher proportion of Hispanic breast cancer patients receiving care at Moores and participating in the I-SPY2 clinical trial. I-SPY2 is a multicenter clinical trial of neoadjuvant chemotherapy – treatment in advance of the primary therapy – in combination with investigational agents for women with a new breast cancer diagnosis.

“Our study shows that with the implementation of the ACA in California, our cancer center’s Hispanic breast cancer patient population increased significantly,” Lalonde said. “We also observed an increase in the proportion of Hispanic women who consented to be part of a national clinical trial, including a substantial increase in Spanish-speaking patients.”

These findings suggest that policy decisions like enacting the ACA can have a measurable impact on patients seeking treatment for their cancer and provide them with more options of where to receive cancer care, Lalonde noted.

Moreover, an increase in the enrollment of Hispanics in the screening phase of the I-SPY2 trial is encouraging evidence of improved equitability in the clinical trial recruitment process, Lalonde added.

In this study, the researchers assessed the number of Hispanic women receiving care for a new breast cancer diagnosis at the cancer center between January 2010 and December 2013, before the implementation of the ACA, and between January 2014 and December 2015, after the implementation of the ACA. They also looked into the cohort of patients who signed up to be screened in order to participate in the I-SPY2 clinical trial during the same time periods.

Lalonde and team found that there was a statistically significant increase in the number of Hispanic women with breast cancer who came to the cancer center for care after implementation of the ACA. Further, the number of Hispanic women who consented to participate in the clinical trial also increased significantly.