{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:11:52Z","timestamp":1789456312881,"version":"build-2803163510"},"reference-count":7,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The One Big Beautiful Bill Act (OBBBA), signed into law in July 2025, introduced sweeping changes to Medicaid financing. Although framed as measures intended to foster independence and fiscal sustainability, these policies risk destabilizing continuity of care for cancer patients. Prostate cancer patients represent a sizeable population that may be impacted by the OBBBA, as prostate cancer is the most commonly diagnosed cancer in men in the United States. Patients with favorable\u2010risk prostate cancer who are managed through active surveillance may in particular be at risk of poor oncologic outcomes due to restructured health care financing. Active surveillance\u2014an evidence\u2010based strategy for managing early\u2010stage prostate cancer\u2014relies on regular monitoring with imaging, laboratory testing, and biopsies. Temporary insurance gaps or modest increases in out\u2010of\u2010pocket costs could disrupt adherence to surveillance schedules, resulting in delayed detection of cancer progression, avoidable overtreatment, or late\u2010stage presentation. Sustainable Medicaid reform is essential, but policies that undermine evidence\u2010based management can heighten disparities, increase long\u2010term costs, and compromise survival in prostate cancer care. Without careful recalibration, the OBBBA risks widening disparities and reversing decades of progress in management of favorable\u2010risk prostate cancer.<\/jats:p>","DOI":"10.1002\/cncr.70186","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T13:41:01Z","timestamp":1764078061000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The One Big Beautiful Bill Act and the future of prostate cancer care"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8162-826X","authenticated-orcid":false,"given":"Aurora J.","family":"Grutman","sequence":"first","affiliation":[{"name":"Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian P.","family":"Pavlovich","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"ArringtonJ.One Big Beautiful Bill Act.2025."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21820"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.12.017"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr1901772"},{"key":"e_1_2_11_6_1","volume-title":"Free for ALL? Lessons From the RAND Health Insurance Experiment","author":"Newhouse JP","year":"1996"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3386\/w21632"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a030387"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70186","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T11:11:20Z","timestamp":1764760280000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.70186"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":7,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/cncr.70186"],"URL":"https:\/\/doi.org\/10.1002\/cncr.70186","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,25]]},"assertion":[{"value":"2025-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70186"}}