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Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

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The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
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Related Experiment Video

Updated: Mar 6, 2026

Laparoscopic Radical Antegrade Modular Pancreatosplenectomy via Dorsal-Caudal Artery Approach for Pancreatic Neck-Body Cancer
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Medicaid Expansion Timing and Pancreatic Cancer Resection Rates and Survival.

Julien T Hohenleitner1,2,3, Rohin Gawdi1,2,4, Oliver J Standring1,2

  • 1Northwell Health, New Hyde Park, New York.

JAMA Surgery
|March 4, 2026
PubMed
Summary
This summary is machine-generated.

Medicaid expansion in the US was linked to reduced mortality and increased surgical resection rates for pancreatic cancer patients. However, improvements were delayed and income-related disparities persisted, indicating a need for further policy interventions.

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Area of Science:

  • Oncology and Public Health Policy
  • Health Services Research
  • Cancer Epidemiology

Background:

  • Pancreatic cancer has a low 5-year survival rate (13%), necessitating research into factors improving patient outcomes.
  • Medicaid expansion presents an opportunity to examine the impact of broader insurance eligibility on pancreatic cancer survival and treatment.

Purpose of the Study:

  • To assess the association between state-level Medicaid expansion and reduced mortality in pancreatic cancer patients.
  • To determine if Medicaid expansion increased surgical resection rates among adults with pancreatic cancer.
  • To investigate variations in these effects across demographic and socioeconomic subgroups.

Main Methods:

  • Observational cohort study utilizing the SEER Research Plus database (2006-2019) across 12 US states.
  • Generalized difference-in-differences Cox and logistic regression models were employed.
  • Patients aged 20-64 with pancreatic cancer were categorized by Medicaid expansion timing (nonexpansion, early, on time, late) and propensity score matched.

Main Results:

  • Medicaid expansion was associated with reduced 2-year all-cause mortality in early, on-time, and late expansion states (HRs ranging from 0.91 to 0.94).
  • Mortality reductions were generally observed after 3 years post-implementation and narrowed geographic disparities in survival.
  • A 19% relative increase in the odds of surgical resection was associated with Medicaid expansion (OR, 1.19).

Conclusions:

  • Medicaid expansion is linked to improved survival and surgical access for pancreatic cancer patients, though with delayed and uneven effects.
  • Persistent income-related disparities underscore the need for additional policies to ensure equitable outcomes.
  • The findings highlight the complex interplay between insurance expansion, socioeconomic factors, and cancer care delivery.