{"id":28362,"date":"2025-07-15T04:26:00","date_gmt":"2025-07-14T20:26:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28362"},"modified":"2025-07-15T05:50:44","modified_gmt":"2025-07-14T21:50:44","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e7%be%8e%e5%9b%bd%e5%90%84%e5%b7%9e%e5%be%81%e7%a8%8e%e6%94%bf%e7%ad%96%e3%80%81%e8%82%bf%e7%98%a4%e7%ad%9b%e6%9f%a5%e4%b8%8e%e7%97%85","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28362","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u7f8e\u56fd\u5404\u5dde\u5f81\u7a0e\u653f\u7b56\u3001\u80bf\u7624\u7b5b\u67e5\u4e0e\u75c5\u6b7b\u7387"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Health Policy<\/p>\n\n\n\n

May 2, 2025<\/p>\n\n\n\n

State-Level Tax Policy, Cancer Screening, and Mortality Rates in the US<\/h1>\n\n\n\n

Odysseas P. Chatzipanagiotou, Mujtaba Khalil, Usama Waqar, et al<\/h3>\n\n\n\n

JAMA Netw Open. <\/em>2025;8(5):e258455. doi:10.1001\/jamanetworkopen.2025.8455<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Are state-level tax revenue and tax progressivity associated with cancer screening and cancer mortality rates in the US?<\/p>\n\n\n\n

Findings<\/strong>  This cross-sectional study of 1150 state-years consisting of tax revenue data for 23 years (1997-2019) and 50 states found that increased tax income was associated with increased cancer screening rates, as well as decreased cancer mortality rates; this association was more prominent among White than racial and ethnic minority populations.<\/p>\n\n\n\n

Meaning<\/strong>  These findings suggest that state-level tax revenue may serve as one aspect of a multifaceted approach to improve cancer-related outcomes in the US and help bridge cancer care gaps, particularly in more progressive tax policy settings.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  The Healthy People 2030 initiative has set national cancer screening targets for breast, colon, and cervical cancers, as well as aims for reducing cancer mortality. State-level tax policy is an underappreciated social determinant of health that may improve cancer screening and mortality rates.<\/p>\n\n\n\n

Objective<\/strong>  To define the association of tax revenue and tax progressivity with state-level cancer screening and mortality.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This ecologic, population-based, cross-sectional study assessed cancer screening (2020 and 2022) and mortality rates (1999-2021) in the US relative to state-level tax revenue (1997-2019) and tax progressivity (2002, 2009, 2012, 2014, and 2018) with a 2-year lag. The study included 50 states through 23 years with state-years used as the unit of analysis. Cancer screening rates were derived from the Centers for Disease Control and Prevention (CDC) Population Level Analysis and Community Estimates database. State-level cancer-related death and population counts were derived from the CDC Wide-Ranging Online Data for Epidemiologic Research database. Data analysis occurred from September to January 2024.<\/p>\n\n\n\n

Exposure<\/strong>  State-level tax policy was proxied by tax revenue per capita and the Suits index of tax progressivity, with progressive taxation equaling lower tax burden for more disadvantaged populations.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Outcomes included screening rates for colon, breast, and cervical cancer, as well as mortality rates for all malignant neoplasms and malignant neoplasms with guideline-recommended screening. Multivariable models were adjusted for tax-related, socioeconomic, and demographic variables.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0In total, 1150 state-years were included in the analysis. Median (IQR) tax revenue per capita was $4432 ($3862-$5210), and the median (IQR) number of cancer-related deaths was 8341 (3150-13\u202f585) across all state-years. Of note, each $1000 increase in tax revenue per capita was associated with a 1.61% (95% CI, 0.50%-2.73%) increase in colorectal cancer screening, 2.17% (95% CI, 1.39%-2.96%) increase in breast cancer screening, and 0.72% (95% CI, 0.34%-1.10%) increase in cervical cancer screening rate. For malignant neoplasms with guideline-recommended screening, each $1000 increase in tax revenue per capita was associated with a decreased cancer mortality rate among White (adjusted incidence rate ratio, 0.95, 95% CI, 0.93-0.98), but not racial and ethnic minority (adjusted incidence rate ratio, 0.99, 95% CI, 0.97-1.02) populations.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this cross-sectional study, tax policy was associated with increased state-level cancer screening rates, as well as decreased cancer mortality rates, which mostly benefited White populations, suggesting that state-level policies may contribute to bridging ongoing cancer care gaps.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Health Policy May 2,& […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28362"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28362"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28362\/revisions"}],"predecessor-version":[{"id":28705,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28362\/revisions\/28705"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28362"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28362"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}