Publications by authors named "Kewei Sylvia Shi"
Article Synopsis
- HR-negative, HER2-positive breast cancer can have favorable outcomes if treated with HER2-targeted therapy, and Medicaid expansion under the ACA may improve care access and effectiveness for this group.
- A study analyzed the impact of Medicaid expansion on treatment adherence, timely initiation of therapy, and survival rates in women aged 18 to 62 diagnosed with this type of breast cancer between 2010 and 2018.
- Results showed that Medicaid expansion led to a slight increase in receiving guideline-concordant treatment and significantly improved timely treatment initiation and 2-year survival rates, especially for those with advanced stage III disease.
Article Synopsis
- The Affordable Care Act removed out-of-pocket costs for recommended preventive services, but a recent court ruling may reinstate these costs for over 150 million Americans, particularly affecting colorectal cancer screenings.
- If the court's decision stands, it could specifically impact screening for colorectal cancer in people aged 45-49 and polyp removals during colonoscopies for all ages.
- A simulation showed that a decrease in screening participation by 8% could lead to a significant rise in colorectal cancer cases and deaths, while potentially reducing costs in the short term due to increased cost-sharing, but higher participation loss could result in greater overall healthcare costs.
Background: Health insurance coverage is critical for ensuring access to recommended health care in the United States. This study investigated the associations of health insurance coverage disruptions, also known as coverage churn, and receipt of breast and colorectal cancer screening.
Methods: Adults who were age-eligible and younger than 65 years (range, 50-64 years) for breast (n = 17,128 women) and colorectal (n = 32,562 individuals) cancer screening were identified from 5 years of the National Health Interview Survey.
This study examined the association of county-level jail and state-level prison incarceration rates and cancer mortality rates in the United States. Incarceration rates (1995-2018) were sourced from national data and categorized into quartiles. County- and state-level mortality rates (2000-2019) with invasive cancer as the underlying cause of death were obtained from the National Vital Statistics System.
View Article and Find Full Text PDFArticle Synopsis
- Cancer survivors sometimes struggle to afford basic needs like food and housing, which can be really tough for their health.
- Researchers studied a big group of cancer survivors to see how these struggles relate to their risk of dying.
- They found that younger survivors with serious struggles had a higher risk of dying, and older survivors with multiple financial issues also faced increased risks.
Context: Despite clinical benefits of early palliative care, little is known about Medicare physician workforce specialized in Hospice and Palliative Medicine (HPM) and their service delivery settings.
Objectives: To examine changes in Medicare HPM physician workforce and their service delivery settings in 2008-2020.
Methods: Using the Medicare Data on Provider Practice and Specialty from 2008 to 2020, we identified 2375 unique Medicare Fee-For-Service (FFS) physicians (15,565 physician-year observations) with self-reported specialty in "Palliative Care and Hospice".
Importance: Medical debt is increasingly common in the US. Little is known regarding its association with population health.
Objective: To examine the associations of medical debt with health status, premature death, and mortality at the county level in the US.
Purpose: Use of genomic testing, especially multimarker panels, is increasing in the United States. Not all tests and related treatments are covered by health insurance, which can result in substantial patient out-of-pocket (OOP) costs. Little is known about oncologists' treatment decisions with respect to patient insurance coverage and OOP costs for genomic testing.
View Article and Find Full Text PDFBackground: Few studies have comprehensively compared health-related quality of life (HRQoL) between metastatic prostate cancer survivors, survivors with non-metastatic disease, and men without a cancer history.
Methods: We used the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS) data linkage to identify men aged ≥ 65 years enrolled in Medicare Advantage (MA) plans. Prostate cancer survivors were diagnosed between 1988 and 2017 and completed MHOS surveys between 1998 and 2019.
Article Synopsis
- The COVID-19 pandemic significantly disrupted access to cancer care, leading to a decrease in various treatment modalities for newly diagnosed cancer patients in 2020.
- A cohort study examined data from over 3.5 million adults diagnosed with solid tumors between 2018 and 2020 to measure these changes.
- Findings revealed approximately 98,000 fewer surgical procedures, 38,800 fewer chemotherapy treatments, and other reductions in cancer therapies during the first year of the pandemic compared to expected treatment based on previous years.
Female breast cancer is a common cancer in young adults, an age group with the highest uninsured rate. Among 51 675 young adult women (ages 18-39 years) diagnosed with breast cancer between 2011 and 2018 in the National Cancer Database, we estimated changes in guideline-concordant treatment receipt, treatment timeliness, and survival associated with the Affordable Care Act Medicaid expansion. Of young adults with stage I-III estrogen receptor-positive or progesterone receptor-positive breast cancer, Medicaid expansion was associated with a net increase of 2.
View Article and Find Full Text PDFBackground: The emergence of COVID-19 disrupted health care, with consequences for cancer diagnoses and outcomes, especially for early stage diagnoses, which generally have favourable prognoses. We aimed to examine nationwide changes in adult cancer diagnoses and stage distribution during the first year of the COVID-19 pandemic by cancer type and key sociodemographic factors in the USA.
Methods: In this cross-sectional study, adults (aged ≥18 years) newly diagnosed with a first primary malignant cancer between Jan 1, 2018, and Dec 31, 2020, were identified from the US National Cancer Database.
Clinical guidelines have endorsed early palliative care for patients with advanced malignancies, but receipt remains low in the US. This study examined the association between Medicaid expansion under the Affordable Care Act and receipt of palliative care among patients newly diagnosed with advanced-stage cancers. Using the National Cancer Database, we found that the percentage of eligible patients who received palliative care as part of first-course treatment increased from 17.
View Article and Find Full Text PDFPurpose: Medicaid expansion through the Affordable Care Act (ACA) has been shown to improve insurance coverage and early diagnosis of cancer in young adults (YAs); whether these improvements translate to survival benefits remains unknown. We examined the association between Medicaid expansion under the ACA and 2-year overall survival among YAs with cancer.
Methods: Using the National Cancer Database, we identified 345,413 YAs (age 18-39 years) diagnosed with cancer in 2010-2017.