Affordable care assessment.

You can’t escape the doomsday repeal and replace debate, even if you try, so it’s probably worth learning what--if any--impact the young Affordable Care Act (ACA) has had on our field in its short life on the books. To assess an anticipated expansion in cancer screenings with the birth of the ACA, a large SEER analysis was performed to detect increases in early stage breast, colorectal or cervical cancer incidences between two time periods: the first nine months of 2013 (pre-ACA) versus the final nine months of 2014 (post-ACA). There was, indeed, a significant increase in incidence of early (and not late) stage breast and colorectal cancers but no difference in cervical cancers. It’s hard to say, of course, if this is really related to the ACA or simply a broader epidemiologic trend that’s been occurring for years. A more important question is the true clinical impact of widespread early detection of small, asymptomatic breast and colon cancers. What’s less questionable: the impact of current screening trends on oncology job security.