Most previous studies comparing stage of cancer at diagnosis between Medicaid and non-Medicaid populations have not accounted for the patient's timing of enrollment in the Medicaid program in relation to the initial date of cancer diagnosis. Findings from this study indicate that Medicaid benefi ciaries having enrolled in the program at least 3 months before breast or cervical cancer diagnosis are significantly less likely to be seen with distant metastases on diagnosis than those enrolling in the Medicaid program shortly before, on, or after cancer diagnosis. Although these results reflect positively on the effectiveness of the Medicaid program in cancer prevention, they also provide support to further enhance cancer-screening efforts in the Medicaid population.
Siran M. Koroukian, PhD, Senior Instructor, Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio.
Corresponding author: Siran M. Koroukian, PhD, Senior Instructor, Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4945 (e-mail: firstname.lastname@example.org).
Dr. Koroukian was supported by a postdoctoral training grant from the National Cancer Institute at the time the study was conducted (#F32 CA84621).
Cancer incidence data were obtained from the Ohio Cancer Incidence Surveillance system (OCISS), Ohio Department of Health. Use of these data does not imply that the Ohio Department of Health either agrees or disagrees with any presentation, analyses, interpretations, or conclusions. Information about the OCISS may be obtained at http://odh.state.oh.us/ODHPrograms/CI_SURV/ci_surv1.htm.
These results were presented in part at the annual meeting of the National Association of Health Data Organizations (NAHDO), December 3, 2001, Washington, DC.
The author thanks Dr. Gregory S. Cooper of the Department of Medicine and the Department of Epidemiology and Biostatistics, Case Western Reserve University, and Ms. Georgette Haydu of the Ohio Cancer Incidence Surveillance System, the Ohio Department of Health and Dr. Rosemary Chaudry, Bureau of Health Plan Policy, Ohio Department of Job and Family Services, for their review of earlier versions of this manuscript and their helpful comments.