The Role of Full Practice Authority for Nurse Practitioners on Advancing Early Cancer Detection.

Abstract

This study investigates the impact of nurse practitioner full practice authority on cancer detection rates in the U.S., focusing on 6 high-prevalence cancers: bladder, cervical, lung, lymphoma, melanoma, and prostate cancers. A difference-in-differences analysis was conducted in February 2025 using nationally representative 2010-2019 data from the Medical Expenditure Panel Survey. Difference-in-differences modeling was used to compare changes in cancer detection before and after full practice authority policy implementation, comparing states with and without full practice authority, with additional adjustments for rurality. The implementation of full practice authority was associated with changes in cancer detection patterns. Statistically significant reductions in bladder cancer detection and increases in cervical cancer and melanoma detection were observed after full practice authority implementation. Effects varied by cancer type and were moderated by rural status, with some associations dissipating in rural counties. No significant changes were detected for lung cancer or lymphoma. Nurse practitioner full practice authority may influence early cancer detection, with variable effects across cancer types and geographic settings. Implementing full practice authority for nurse practitioners could enhance access to preventive oncology care, particularly in underserved areas. Further research is needed to assess long-term clinical outcomes and stage at diagnosis.