Implications of the initial Braidwood v. Becerra ruling for colorectal cancer outcomes: A modeling study Journal Article
| Authors: | Van Den Puttelaar, R.; Shi, K. S.; Smith, R.; Zhao, J.; Ogongo, M. K.; Harlass, M.; Hahn, A. I.; Zauber, A. G.; Yabroff, K. R.; Lansdorp-Vogelaar, I. |
| Article Title: | Implications of the initial Braidwood v. Becerra ruling for colorectal cancer outcomes: A modeling study |
| Abstract: | The Affordable Care Act (ACA) eliminated patient cost-sharing for United States Preventive Service Task Force (USPSTF) recommended services. However, if the US Court of Appeals for the Fifth Circuit fully upheld a US District Court ruling in Braidwood Management v. Becerra, 666 F. Supp. 3d 613 (N.D. Tex 2023), cost-sharing for USPSTF recommendations made after ACA passage would have been reinstated for more than 150 million people. The case would have reinstated cost-sharing for colorectal cancer (CRC) screening for ages 45-49 years and for polyp removal during (diagnostic) colonoscopy across all ages. Using the MISCAN-Colon model, we simulated the potential impact on CRC outcomes, assuming early-onset CRC trends and lower screening participation. An 8-percentage-point decline in screening participation could increase CRC incidence by 5.1% and CRC mortality by 9.1%, with slightly lower costs due to increased cost-sharing. Larger decreases in screening participation can result in higher costs from increased incidence and delayed diagnoses. © The Author(s) 2024. Published by Oxford University Press. |
| Keywords: | aged; middle aged; mortality; united states; follow up; cancer incidence; sensitivity analysis; colorectal cancer; cancer screening; mass screening; cancer mortality; colorectal neoplasms; health care policy; cost effectiveness analysis; health care cost; economics; tumor burden; colonoscopy; colorectal tumor; diagnosis; delayed diagnosis; epidemiology; early detection of cancer; quality adjusted life year; cost; model; health care planning; polyp; clinical outcome; preventive health service; cost sharing; patient protection and affordable care act; humans; human; male; female; article; early cancer diagnosis; health legislation |
| Journal Title: | JNCI: Journal of the National Cancer Institute |
| Volume: | 117 |
| Issue: | 4 |
| ISSN: | 0027-8874 |
| Publisher: | Oxford University Press |
| Date Published: | 2025-04-01 |
| Start Page: | 790 |
| End Page: | 794 |
| Language: | English |
| DOI: | 10.1093/jnci/djae244 |
| PUBMED: | 39361402 |
| PROVIDER: | scopus |
| PMCID: | PMC11972676 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Source: Scopus |
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