《患者保护和平价医疗法案》(ACA) 允许 19-25 岁的美国人在 26 岁之前继续享受父母的健康保险计划（家属护理扩展 [DCE]）。那些被诊断患有癌症的人是否受益？将 ACE DCE 7 岁年龄范围（19-25 岁）与较年轻和较年长的群体（在 7 年年龄跨度中）比较 ACA 颁布前后癌症存活率和死亡率的变化：分别为 12-18 岁和 26-32 岁）。整个美国的癌症死亡数据来自疾病控制和预防中心，被诊断患有癌症的患者的相对生存数据来自国家癌症研究所监测、流行病学和最终结果区域，占 42%-44 Joinpoint 分析确定，符合 DCE 资格的队列是所评估的三个组中唯一一个在 ACA 实施后癌症生存率和死亡率趋势均有所改善的年龄组，并且 2010 年（ACA 通过的年份）是生存和死亡的拐点年份。到 6 年时，DCE 合格年龄组的癌症诊断后相对生存率分别比年轻对照组和老年对照组高 2.6 倍和 3.9 倍（均 p < 0.001），并且 DCE 合格年龄组的癌症死亡率分别高出 2.6 倍和 3.9 倍（均 p < 0.001）。符合条件的年龄组的改善分别比年轻和年长对照年龄组提高了 2.1 倍和 1.5 倍（均 p < .01）。在 ACA 的第一个十年期间，符合条件的年轻癌症患者的生存率和死亡率显着提高。需要额外的政策来扩大保险覆盖范围并帮助年轻人进行早期癌症诊断。2011 年在美国开始的患者保护和平价医疗法案 (ACA) 家属护理扩展 (DCE) 允许 19-25 岁的年轻人留下来参加父母的健康保险计划直至 26 岁。与较年轻和较年长的年龄组相比，符合 DCE 年龄组的诊断为癌症的年轻成年患者 6 年生存率提高了 2.6 至 3.9 倍，癌症死亡率则提高了 1.5 至 2.1 倍。在平价医疗法案实施的第一个十年中，符合条件的年轻癌症患者的生存期显着延长，癌症死亡人数显着减少。年轻人需要扩大保险覆盖范围并允许更快诊断癌症的额外政策。© 2024 美国癌症协会。

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.© 2024 American Cancer Society.