通过《负担得起的护理法》依赖覆盖范围扩张后，年轻人的癌症患者的生存率改善和癌症死亡减少

《患者保护和负担得起的护理法案》（ACA）允许19-25岁的美国人一直遵守父母的健康保险计划，直到26岁（依赖的护理扩张[DCE]）。患有癌症诊断的人是否受益？ACE DCE的7岁年龄范围为19-25岁，在ACA颁布前后的癌症生存和死亡率变化与年龄较小的组（分别在7岁时：12-18岁和26-32岁的年龄段））。从疾病控制和预防的中心获得了整个美国的癌症死亡数据，并从国家癌症研究所的监视，流行病学和最终结果区域中获得了诊断为癌症的患者的相对存活数据，并且最终结果区域占该国家的42％-44％。Joinpoint分析在三个属性群体中都鉴定出了癌症的范围。实施和2010年ACA通过的那一年是生存和死亡的拐点年份。到6岁时，癌症诊断后的相对存活率分别比年轻和年龄较大的对照组（均为p <.001）高2.6倍和3.9倍，DCE年龄组的癌症死亡率分别提高了2.1和1.5倍，比年轻的年龄较大的成年人分别高于p <.01。提高生存和死亡率。需要在年轻人中扩大保险范围并实现早期癌症诊断的其他政策。《患者保护和负担得起的护理法》（ACA）依赖的护理扩张（DCE）于2011年开始于美国开始，使年龄在19-25岁之间的年轻人保持父母的健康保险计划，直到26岁。与年轻和年龄较大的年龄段相比，在符合DCE的年龄段的年轻患者的6岁年轻患者的生存率是2.6至3.9倍，癌症的死亡率提高了1.5至2.1倍。在ACA的头十年中，在合格组中患有癌症的年轻人的存活率明显更长，癌症死亡减少了。在年轻人中需要更快地需要扩大保险范围并允许诊断癌症的其他保单。

The Patient Protection and Affordable Care Act (ACA) allowed Americans aged 19-25 years to remain on their parents' health insurance plans until age 26 years (the Dependent Care Expansion [DCE]). Have those with cancer diagnoses benefited?The ACE DCE 7-year age range of 19-25 years was compared for changes in cancer survival and mortality before and after enactment of the ACA with groups that were younger and older (in 7-year age spans: ages 12-18 and 26-32 years, respectively). Cancer death data for the entire United States were obtained from the Centers for Disease Control and Prevention, and relative survival data of patients who were diagnosed with cancer were obtained from the National Cancer Institute Surveillance, Epidemiology, and End Results regions representing 42%-44% of the country.Joinpoint analysis identified the DCE-eligible cohort as the only age group of the three groups evaluated that have had improvements in both cancer survival and death rate trends after ACA implementation and that 2010, the year the ACA was passed, was the inflection year for both survival and deaths. By 6 years, the relative survival after cancer diagnosis was 2.6 and 3.9 times greater in the DCE-eligible age group than in the younger and older control groups, respectively (both p < .001), and the cancer death rate in the DCE-eligible age group improved 2.1 and 1.5 times greater than in the younger and older control age groups, respectively (both p < .01).During the first decade of the ACA, eligible young adults with cancer have had significantly improved survival and mortality. Additional policies expanding insurance coverage and enabling earlier cancer diagnosis among young adults are needed.The Patient Protection and Affordable Care Act (ACA) Dependent Care Expansion (DCE) that began in the United States in 2011 allowed young adults aged 19-25 years to remain on their parents' health insurance plans until age 26 years. The survival rate at 6 years in young adult patients diagnosed with cancer was 2.6 to 3.9 times greater in the DCE-eligible age group compared with the younger and older age groups, and the rate of deaths from cancer improved 1.5 to 2.1 times more. During the first decade of the ACA, young adults with cancer who were in the eligible group had significantly longer survival and reduced deaths from cancer. Additional policies that expand insurance coverage and allow the diagnosis of cancer sooner are needed in young adults.