{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T12:43:54Z","timestamp":1771332234182,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The clinical impact of Medicaid expansion in otolaryngology is uncertain. Herein, we evaluate the impact of Medicaid expansion on treatment patterns (primary radiotherapy vs surgery) in the early glottic cancer population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data regarding adults with Tis\u2010T2N0M0 glottic cancer that were treated with either surgery or radiotherapy between January 2010 and December 2016 were obtained from the Surveillance, Epidemiology, and End Results (SEER) cancer database. Changes in treatment trends and survival in the Medicaid expansion setting were discerned.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of patients undergoing radiotherapy decreased from 64.8% to 59% after the Patient Protection and Affordable Care Act (PPACA) was implemented. State Medicaid expansion status was associated with reduced odds of radiation therapy (odds ratio [OR] = 0.66). Patients were diagnosed more often with earlier stage disease (20.6% vs 17.0% T2 diagnoses) in the Medicaid expansion cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The implementation of the PPACA was associated with a significant increase in surgical therapy for and earlier diagnosis of glottic cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.26463","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T09:59:04Z","timestamp":1600423144000},"page":"137-144","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Changes in treatment trends in the early glottic cancer population after the Affordable Care Act"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1149-9532","authenticated-orcid":false,"given":"Bharat Akhanda","family":"Panuganti","sequence":"first","affiliation":[{"name":"Division of Otolaryngology \u2013 Head and Neck Surgery, Department of Surgery University of California \u2013 San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emelia","family":"Stuart","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California \u2013 Davis  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Weissbrod","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2013 Head and Neck Surgery, Department of Surgery University of California \u2013 San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13077"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28066"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21442"},{"key":"e_1_2_7_5_1","unstructured":"Actual and Projected Cancer Incidence Rates United States 1975 to 2020|CDC.https:\/\/www.cdc.gov\/cancer\/dcpc\/research\/articles\/cancer_2020_incidence.htm. Published January 31 2019. Accessed February 7 2020."},{"key":"e_1_2_7_6_1","unstructured":"Cancer of the Larynx \u2013 Cancer Stat Facts. SEER.https:\/\/seer.cancer.gov\/statfacts\/html\/laryn.html. Accessed January 20 2020."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815577103"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.1525"},{"key":"e_1_2_7_9_1","first-page":"5","article-title":"Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer","volume":"2","author":"Dey P","year":"2002","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2016.03.025"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.2724"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.1792"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.3467"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000970"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001177"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.26463","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.26463","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.26463","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T16:15:16Z","timestamp":1693757716000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.26463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,18]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1002\/hed.26463"],"URL":"https:\/\/doi.org\/10.1002\/hed.26463","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,18]]},"assertion":[{"value":"2020-06-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}