Table 1.
Characteristics of newly diagnosed young adult cancer patients aged 18-39 years, 2011-2016a
| Characteristics | Total, No. (%) | Medicaid expansion states, | Nonexpansion states, | P b |
|---|---|---|---|---|
| No. (%) | No. (%) | |||
| Total No. | 309 413 | 193 109 | 116 304 | |
| Sex | <.001 | |||
| Male | 114 901 (37.1) | 72 386 (37.5) | 42 515 (36.6) | |
| Female | 194 512 (62.9) | 120 723 (62.5) | 73 789 (63.4) | |
| Age, y | <.001 | |||
| 18-25 | 54 366 (17.6) | 34 733 (18.0) | 19 633 (16.9) | |
| 26-34 | 133 945 (43.3) | 83 763 (43.4) | 50 182 (43.1) | |
| 35-39 | 121 102 (39.1) | 74 613 (38.6) | 46 489 (40.0) | |
| Race or ethnicity | <.001 | |||
| Non-Hispanic White | 208 684 (67.4) | 132 768 (68.8) | 75 916 (65.3) | |
| Non-Hispanic Black | 36 668 (11.9) | 18 333 (9.5) | 18 335 (15.8) | |
| Hispanic | 40 033 (12.9) | 24 243 (12.6) | 15 790 (13.6) | |
| Non-Hispanic other | 20 273 (6.6) | 15 040 (7.8) | 5233 (4.5) | |
| Unknown | 3755 (1.2) | 2725 (1.4) | 1030 (0.9) | |
| Zip code–level median household income | <.001 | |||
| Low (≤138 FPL) | 22 314 (7.2) | 12 098 (6.3) | 10 216 (8.8) | |
| Middle (139-400 FPL) | 258 544 (83.6) | 159 592 (82.6) | 98 952 (85.1) | |
| High (>401 FPL) | 27 085 (8.8) | 20 259 (10.5) | 6826 (5.9) | |
| Unknown | 1470 (0.5) | 1160 (0.6) | 310 (0.3) | |
| Residence MSA status | <.001 | |||
| Metropolitan | 262 625 (84.9) | 166 841 (86.4) | 95 784 (82.4) | |
| Non-MSA urban | 35 022 (11.3) | 19 414 (10.1) | 15 608 (13.4) | |
| Non-MSA rural | 3786 (1.2) | 1716 (0.9) | 2070 (1.8) | |
| Unknown | 7980 (2.6) | 5138 (2.7) | 2842 (2.4) | |
| Year of cancer diagnosis | .02 | |||
| 2011 | 49 203 (15.9) | 30 674 (15.9) | 18 529 (15.9) | |
| 2012 | 50 570 (16.3) | 31 280 (16.2) | 19 290 (16.6) | |
| 2013 | 51 331 (16.6) | 32 138 (16.6) | 19 193 (16.5) | |
| 2014 | 52 573 (17.0) | 33 046 (17.1) | 19 527 (16.8) | |
| 2015 | 53 438 (17.3) | 33 246 (17.2) | 20 192 (17.4) | |
| 2016 | 52 298 (16.9) | 32 725 (16.9) | 19 573 (16.8) | |
| Cancer stage at diagnosis | <.001 | |||
| I | 139 855 (45.2) | 89 478 (46.3) | 50 377 (43.3) | |
| II | 49 335 (15.9) | 30 416 (15.8) | 18 919 (16.3) | |
| III | 35 399 (11.4) | 21 507 (11.1) | 13 892 (11.9) | |
| IV | 28 628 (9.3) | 17 397 (9.0) | 11 231 (9.7) | |
| Unknownc | 15 553 (5.0) | 9465 (4.9) | 6088 (5.2) | |
| Not applicabled | 40 643 (13.1) | 24 846 (12.9) | 15 797 (13.6) | |
| Cancer site | <.001 | |||
| Thyroid | 55 048 (17.8) | 36 403 (18.9) | 18 645 (16.0) | |
| Female breast | 46 687 (15.1) | 28 525 (14.8) | 18 162 (15.6) | |
| Testis | 23 699 (7.7) | 15 504 (8.0) | 8195 (7.0) | |
| Melanoma | 20 554 (6.6) | 13 303 (6.9) | 7251 (6.2) | |
| Colon or rectum | 15 161 (4.9) | 9121 (4.7) | 6040 (5.2) | |
| Non-Hodgkin lymphoma | 15 225 (4.9) | 9569 (5.0) | 5656 (4.9) | |
| Cervix | 14 445 (4.7) | 8171 (4.2) | 6274 (5.4) | |
| Hodgkin lymphoma | 14 600 (4.7) | 9298 (4.8) | 5302 (4.6) | |
| Other | 103 994 (33.6) | 63 215 (32.7) | 40 779 (35.1) | |
| Brain or other nervous system | 14 168 (4.6) | 8785 (4.5) | 5383 (4.6) | |
| Leukemia | 13 766 (4.4) | 8381 (4.3) | 5385 (4.6) | |
| Kidney | 10 375 (3.4) | 6140 (3.2) | 4235 (3.6) | |
| Uterus | 8007 (2.6) | 4708 (2.4) | 3299 (2.8) | |
| Soft tissue including heart | 7048 (2.3) | 4299 (2.2) | 2749 (2.4) | |
| Lung | 4502 (1.5) | 2758 (1.4) | 1744 (1.5) | |
| Ovary | 6204 (2.0) | 3777 (2.0) | 2427 (2.1) | |
| Oral cavity or pharynx | 5981 (1.9) | 3647 (1.9) | 2334 (2.0) | |
| Bones or joints | 3299 (1.1) | 1952 (1.0) | 1347 (1.2) | |
| Stomach | 3028 (1.0) | 1912 (1.0) | 1116 (1.0) | |
| All other rare cancers | 22 249 (7.2) | 13543 (7.0) | 8706 (7.5) | |
a
Authors’ analysis of the 2011-2016 National Cancer Database. FPL = federal poverty level; MSA = metropolitan statistical area.
b
P values were from 2-sided χ2 tests.
c
Included patients (<0.1%) with occult stage.
d
Cancers without an applicable American Joint Committee Classification (AJCC) staging scheme; these cancers were excluded in our analysis of stage at diagnosis.