Impact of Affordable Care Act on the Treatment and Outcomes for Stage-IV Colorectal Cancer

Abstract Background Patients with advanced cancers are among the most vulnerable group of patients. We sought to analyze the impact of Affordable Care Act (ACA) on the interaction of socioeconomic factors with treatment and survival in patients with metastatic colorectal cancers. Methods National Cancer Database (NCDB) was queried for patients with Stage-IV colon(C-Ca) and rectal cancers(R-Ca) diagnosed 2004-2015 and excluded those who did not receive any therapies within 6 months of diagnosis. Enrollment-rates were calculated as receipt of primary therapy as the incident-event (numerator) over time-to-initiation of therapy (denominator) and used to calculate incident-rate ratios that was analyzed using Poisson regression analysis- reported as enrollment-rate ratios (ER, Results For C-Ca, enrollment to primary therapies was significantly associated (p-value Conclusion The ACA appears to have had a positive impact overall but further research and ongoing interventions are warranted to mitigate disparities in this population.