2014 年，《平价医疗法案》扩大了选择参与的州的医疗补助覆盖范围。描述医疗补助扩大对癌症筛查影响的可用数据有限。我们研究的目的是评估与医疗补助扩展相关的宫颈癌筛查趋势。利用行为风险因素监测系统的数据，我们确定了年龄在 30-64 岁、家庭收入低于 35,000 美元的女性受访者。结果测量是遵循指南的宫颈癌筛查。 2010年和2012年为扩张前时期，2016年和2018年为扩张后时期。进行双重差分 (DID) 分析，以评估医疗补助扩展州与非扩展州相比，针对总体样本和每个扩展州的宫颈癌筛查变化。总体 DID 分析显示，与非扩张状态相比，扩张状态下的宫颈癌筛查提高了 1.1 个百分点（95% CI：0.1 至 2.0%，P = 0.03）。对各个扩张州与非扩张州进行比较的分析表明，6 个扩张州的筛查增幅明显高于非扩张州：俄勒冈州（8.5%，P < 0.001）、肯塔基州（4.5%，P = 0.001）、华盛顿州（4.2%，P = 0.002）、科罗拉多州（4.3%，P = 0.008）、内华达州（4.7%，P = 0.048）和俄亥俄州（2.8%，P = 0.03）。在这些州中，有 5 个州位居基线筛查率最低的州之列。相对于未扩大医疗补助的州，医疗补助扩大的州的宫颈癌筛查增加幅度更大。基线筛查率较低的扩张州在扩大医疗补助计划后，筛查率出现了更大的增长。版权所有 © 2024 Elsevier Inc. 保留所有权利。

In 2014 the Affordable Care Act expanded Medicaid coverage in states that opted to participate. Limited data are available describing the effect of Medicaid expansion on cancer screening. The objective of our study was to evaluate trends in cervical cancer screening associated with Medicaid expansion.Using data from the Behavioral Risk Factor Surveillance System, we identified female respondents ages 30-64 years with a household income below $35,000. The outcome measure was guideline-adherent cervical cancer screening. The years 2010 and 2012 constituted the pre-expansion period while 2016 and 2018 were used to capture the post-expansion period. A difference-in-difference (DID) analysis was performed to assess changes in cervical cancer screening in Medicaid expansion states compared to non-expansion states, for the overall sample and for each expansion state individually.The overall DID analysis showed a greater increase in cervical cancer screening by 1.1 percentage points (95% CI: 0.1 to 2.0%, P = 0.03) in expansion states compared to non-expansion states. The analysis comparing individual expansion states to non-expansion states showed that 6 expansion states had a significantly higher increase in screening relative to non-expansion states: Oregon (8.5%, P < 0.001), Kentucky (4.5%, P = 0.001), Washington (4.2%, P = 0.002), Colorado (4.3%, P = 0.008), Nevada (4.7%, P = 0.048), and Ohio (2.8%, P = 0.03). Of these states, 5 ranked among the states with the lowest baseline screening rates.Medicaid expansion states experienced a greater increase in cervical cancer screening relative to non-expansion states. Expansion states with lower baseline screening rates experienced greater increases in screening after expanding Medicaid.Copyright © 2024 Elsevier Inc. All rights reserved.