Impact of health insurance-related policy changes on the incidence of late-stage breast cancer diagnoses in Oklahoma women diagnosed during 2000–2007

Background: In 2000, Congress passed the Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA). We aimed to examine the impact of the BCCPTA on the incidence of late-stage breast cancer in women living in Oklahoma while controlling for other important factors, such as insurance status and the urbanicity of the woman's residence. Methods: Data were obtained from the Oklahoma Central Cancer Registry from 2000 to 2007. Analyses were performed on individual-level variables of race, age, insurance status, residential status, and timing related to the BCCPTA, and ecologic variables of federal poverty level and education level. We used descriptive statistics and logistic regression to analyze the relationship between the proportion of women diagnosed with late-stage breast cancer and the independent variables. Results: We found that the proportion of late-stage breast cancers in women were not different after compared to before the BCCPTA (OR: 1.05, 95% CI: 0.99, 1.12). Those with Medicaid (OR: 0.90, 95% CI: 0.73, 1.10) and uninsured (OR: 0.83, 95% CI: 0.58, 1.18) had a lower odds of being diagnosed with late-stage breast cancer after compared to before the BCCPTA, although this finding was not significant. Discussion: Oklahoma implemented the BCCPTA in a novel way and we looked at its implementation using high quality extant data. Although not significant, our findings show improved outcomes in women with Medicaid after the BCCPTA and in uninsured women. More years of follow-up data may be required to fully appreciate the effect the BCCPTA had in Oklahoma.