Removing out-of-pocket expenditures may lead to increased use of certain cancer preventive services, according to a study involving elderly men and women. However, for colonoscopy, other deterrents may play a role.

Female participants had not had a mammography in the prior 2 years. Males were at increased risk for colorectal cancer and had not had a colonoscopy in the previous 5 years. Investigators looked at procedure use before and after implementation of the Affordable Care Act, as well as the link between use and income and education level. Among the results:

• Lower socioeconomic status was linked with less use of mammography before and after ACA implementation; post-ACA disparities were smaller.
• Mammography rates increased over the study period in all socioeconomic categories.
• There was a link between increased colonoscopy use and education level throughout the study period.
• There were no appreciable changes in colonoscopy and socioeconomic status after implementation of the ACA.