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This study investigated the association between the Affordable Care Act (ACA), which expanded insurance coverage, and receipt of guideline\u2010concordant adjuvant chemotherapy for non\u2010small cell lung cancer (NSCLC) and colon cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Our retrospective study includes data from Pennsylvania Cancer Registry for patients aged 26\u201364 with Stage 3 colon cancer or Stage IIB\/Stage IIIA\/Stage IIIB NSCLC between 2010\u20132019. Based on review of literature and National Comprehensive Cancer Network guidelines, we focused on receipt of adjuvant chemotherapy as our measure of guideline\u2010concordant care. We employed interrupted time series analysis to assess changes in level and annual trend of receipt of adjuvant chemotherapy following ACA implementation. Analyses were performed overall and by subgroups defined by race\/ethnicity, rurality, and ADI quartile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across the study period, 83.9% of colon cancer and 61.7% of NSCLC patients received chemotherapy after surgery. Post\u2010ACA, we observed a non\u2010significant increase in annual rate (slope change) of post\u2010operative colon cancer patients receiving guideline\u2010concordant chemotherapy (+0.74 percentage points per year (pppy),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.68), with larger, non\u2010significant increases among non\u2010White patients (+7.73 pppy,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.16), rural residents (+9.74 pppy,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05), and those from ADI Q4 (high deprivation) neighborhoods (+3.92 pppy,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.24). For NSCLC, there was a non\u2010significant decrease in annual rate of receipt of guideline\u2010concordant chemotherapy (\u22121.34 pppy,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.30).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There were no statistically significant trends in our primary models. Estimates suggest potential increases in receipt of guideline\u2010concordant chemotherapy for post\u2010operative colon cancer patients post\u2010ACA, overall and among underserved groups, and potential decreases in receipt of guideline\u2010concordant chemotherapy for NSCLC patients post\u2010ACA, overall and among underserved groups. These findings warrant further study of linkages between comprehensive insurance coverage and disparities in colon cancer and NSCLC care and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72093","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:14:28Z","timestamp":1783570468000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of the Affordable Care Act With Receipt of Guideline\u2010Concordant Adjuvant Chemotherapy for Colon and Non\u2010Small Cell Lung Cancer"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2591-1778","authenticated-orcid":false,"given":"Sriya","family":"Kudaravalli","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania 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