Health Care Expansion Tied to Increased Rates of Surgical Treatment of Thyroid Cancer

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Health care reform in Massachusetts was associated with more patients opting for thyroidectomy as treatment.
Health care reform in Massachusetts was associated with more patients opting for thyroidectomy as treatment.

Massachusetts health care reform was tied to a 26% increase in access to thyroidectomy for thyroid cancer, according to a study published in JAMA Surgery.

According to the paper, thyroid cancer is the fifth most common cancer in women with an increasing incidence compared to other cancers. With the expansion of access to health insurance with the Affordable Care Act and health care reform, there has been limited research into the impact of insurance status on thyroid cancer treatment.

Andrew P. Loehrer, MD, MPH, a clinical fellow in Complex General Surgical Oncology at MD Anderson Cancer Center, and colleagues sought to identify any change in thyroidectomy rate in thyroid cancer treatment after health insurance expansion in Massachusetts.

Data was collected from the Agency for Healthcare Research and Quality State Inpatient Database on patients admitted to the hospital for thyroidectomy for thyroid cancer. The study included 8534 patients in Massachusetts and 48,047 patients from 3 control states.

Compared to control states, the insurance expansion in Massachusetts was associated with a 26% increase in thyroidectomy (incident rate ratio 1.26, 95% CI: 1.04-1.52, P =.02). Further, the Massachusetts group had a 22% increased rate of neck dissection compared to the control states (incident rate ratio 1.22, 95% CI 1.07-1.37, P =.002).

“Our study suggests that insurance expansion may be associated with increased access to the surgical management of thyroid cancer. Further studies need to be conducted to evaluate the effect of health care expansion at a national level,” the investigators write.


1. Loehrer AP, Murthy SS, Song Z, Lubitz CC, James BC. Association of insurance expansion with surgical management of thyroid cancer [published online April 5, 2017]. JAMA Surg. doi: 10.1001/jamasurg.2017.0461

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