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    Testis cancer patients fare poorly under ACA

    Since passage of the Affordable Care Act (ACA) in 2010, the number of testicular cancer patients with insurance has dwindled, while rates of advanced testis cancer have climbed, according to a new study presented at the Genitourinary Cancers Symposium in Orlando, FL.

    The ACA, intended to increase insurance coverage and health care access, hasn’t had those effects on testicular cancer, which is diagnosed at an average age of 33 years and is the most common cancer in men ages 15 to 44 years, according to the study.

    The not-yet-published research offers two important take-home messages for urologists. One is the burden of testicular cancer, in terms of patients with stage 2 and 3 testicular cancer, which often requires multimodal treatment, hasn’t decreased. And the ACA did not necessarily improve disease detection of testicular cancer among young men in the U.S., according to senior author Simon P. Kim, MD, MPH, of University Hospitals Case Medical Center and the Urology Institute at Case Western Reserve University School of Medicine, Cleveland.

    Dr. Kim told Urology Times that he was surprised by the results.

    Read: Hypofractionated IMRT outcomes comparable to standard regimen

    “Other studies have shown that the Affordable Care Act improved access to health insurance for young patients, and, once they get access, early detection for locally advanced cancers, such as cervical cancer,” Dr. Kim said.

    The authors studied insurance status changes and post-orchiectomy definitive therapy timeliness among men diagnosed with testicular cancer from 2007 to 2013. They identified patients from the National Cancer Database who were 18 to 50 years of age and had undergone radical orchiectomy. The men had stages 1 through 3 testicular cancer. Their insurance types at the time of diagnosis, as well as the times to secondary therapy—systemic chemotherapy, radiation therapy, or retroperitoneal lymph node dissection—were recorded.

    The authors divided patients in groups of 2007 to 2009, or pre ACA, and 2011 to 2013, or post ACA.

    Of the 17,945 men in the study, 53.5% had pure seminoma and 46.5% had nonseminomatous germ cell tumors. The authors found that while 74.1% of the men were privately insured pre ACA, 71.2% were so post ACA. The percentage of men without any health insurance increased slightly from 12.7% before ACA to 13.4% after.

    Next: What the authors found

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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    • [email protected]
      With the propensity for men to procrastinate when it comes to health care, and the very high deductibles that now are the norm, it is not a wonder that there is a higher rate of cancers that are stage 2 and 3. When you have $5000 of first dollar expense people think twice about going to be treated for anything.
    • Anonymous
      I am sorry to say this but doesn't this article point more towards the general problems of healthcare delivery in the USA rather than which particular method of healtcare cover is being used. The NHS may have its shortcomings - of which there are plenty - but this isn't one of them!


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