Category: ACTIONS

Digital transformation: Health systems’ investment priorities

Health systems around the world are facing a host of challenges, including rising costs, clinical-workforce shortages, aging populations requiring more care (for example, to treat chronic conditions), and increasing competition from nontraditional players.1 At the same time, consumers are expecting new capabilities (such as digital scheduling and telemedicine) and better experiences from health systems across their end-to-end care journeys.2 In response, health systems are increasing their focus on digital and AI transformation to meet consumer demands, address workforce challenges, reduce costs, and enhance the overall quality of care.3 However, despite acknowledging the importance of these efforts to future sustainability, many health system executives say their organizations are still not investing enough.

AI, traditional machine learning, and deep learning are projected to result in net savings of up to $360 billion in healthcare spending.

AI, traditional machine learning, and deep learning are projected to result in net savings of $200 billion to $360 billion in healthcare spending.4 But are health systems investing to capture these opportunities? We recently surveyed 200 global health system executives about their digital investment priorities and progress.5 Seventy-five percent of respondents reported their organizations place a high priority on digital and analytics transformation but lack sufficient resources or planning in this area.

Increasing prioritization

In line with other industries, the majority (nearly 90 percent) of health system executives surveyed, in both technical roles (such as chief information officer or chief technology officer) and nontechnical roles (for example, CEO or CFO), reported that a digital and AI transformation is a high or top priority for their organization. At the same time, 75 percent of respondents reported their organizations are not yet able to deliver on that priority because they have not sufficiently planned or allocated the necessary resources.


Health system digital investment priority areas and anticipated impact

For health system executives, current investment priorities do not always align with areas they believe could have the most impact. There is alignment in some areas, including virtual health and digital front doors, where about 70 percent of respondents expect the highest impact.1 In other areas, such as AI, 88 percent of respondents reported a high potential impact,2 yet about 20 percent of respondents do not plan to invest in the next two years. The absence of investment in a robust, modern data and analytics platform could delay value creation in areas that depend on these capabilities—such as efforts to close gaps in care, improve timely access for referrals, and optimize operating room throughput.

Major headwinds and slow progress

Given the current macroeconomic climate and increasing cost pressures on health systems, most respondents identified budget constraints as a key obstacle to investing at scale across all digital and AI categories of interest (51 percent of respondents ranked this obstacle among the top three). For example, a health system that is building a digital front door may lack the resources to simultaneously invest in the latest generative AI (gen AI) capabilities.

Respondents called out challenges with legacy systems as the second-greatest concern (after budget constraints). Core tech modernization is key to delivering on the digital promise,1 but health systems have typically relied on a smaller set of monolithic systems that have become a challenge to untangle.

Additional highly ranked challenges include data quality (33 percent), tech talent and recruiting (30 percent), and readiness to adopt and scale new technology (34 percent).

Satisfaction with digital investment

Most executives of health systems that have invested in digital priorities (72 percent) reported satisfaction across all investment areas. Among the comparatively fewer respondents who reported investing in robotics and advanced analytics, satisfaction was even higher, at 82 percent and 81 percent, respectively. Given that investments result in a high level of satisfaction and that 75 percent of executives reported they are not yet able to deliver on their digital transformation ambitions (as noted above), health systems may be facing a failure to scale their digital programs.

What health systems can do and how they can learn from other industries

The goal of digital and AI transformation is to fundamentally rewire how an organization operates, building capabilities to drive tangible business value (such as patient acquisition and experience, clinical outcomes, operational efficiency, and workforce experience and retention) through continuous innovation. Delivering digital value for health systems requires investment and new ways of working.

Building partnerships. Scale is crucial to value creation. But the definition of at-scale systems has changed in the past few years; today, it takes more than $13 billion to be a top 20 system by revenue, and many have reached their current position through inorganic growth.6 Partnerships (joint ventures and alliances) may offer a promising avenue to access new capabilities, increase speed to market, and achieve capital, scale, and operational efficiencies.7

Moving beyond off-the-shelf solutions. History shows that deploying technology—such as electronic health records (EHRs)—on top of broken processes and clinical workflows does not lead to value. Realizing value from healthcare technology will require a reimagination (and standardization) of clinical workflows and care models across organizations. For example, optimizing workflows to enable more appropriate delegation, with technical enablement, could yield a potential 15 to 30 percent net time savings over a 12-hour shift. This could help close the nursing workforce gap by up to 300,000 inpatient nurses.8

Using the cloud for modernization. Health systems are increasingly building cloud-based data environments with defined data products to increase data availability and quality. Health systems can also use cloud-hosted, end-user-focused platforms (such as patient or clinician apps) that integrate multiple other applications and experiences to simplify stakeholders’ interactions with the system.

Operating differently. Operating differently entails fundamental changes in structure (flatter, empowered, cross-functional teams), talent (new skill sets and fully dedicated teams), ways of working (outcome orientation, agile funding, and managing products, not projects), and technology (modular architecture, cloud-based data systems, and reduced reliance on the monolithic EHR). With these changes, some health systems have begun to see real value within six months. Building a digital culture helps the transformation succeed over time.9

Cautiously embracing gen AI. Gen AI has the potential to affect everything from continuity of care and clinical operations to contracting and corporate functions. Health system executives and patients have concerns about the risks of AI, particularly in relation to patient care and privacy. Managing these risks entails placing business-minded legal and risk-management teams alongside AI and data science teams.10 Organizations could also implement a well-informed risk-prioritization strategy.

Digital and AI investments provide health systems with opportunities to address the many challenges they face. Successful health systems will invest in areas with the greatest potential impact while removing barriers—for example, by upgrading legacy infrastructure. Health systems that make successful investments in digital and analytics capabilities could see substantial benefits and position themselves to benefit from the $200 billion to $360 billion opportunity.11

ABOUT THE AUTHOR(S)
Jack Eastburn is a partner in McKinsey’s Southern California office; Jen Fowkes is a partner in the Washington, DC, office; and Karl Kellner is a senior partner in the New York office. Brad Swanson is a consultant in the Denver office.

The authors wish to thank David Bueno, Camilo Gutierrez, Dae-Hee Lee, Audrey Manicor, Lois Schonberger, and Tim Zoph for their contributions to this article.

Πηγή: mckinsey.com
find more :https://eefam.gr/digital-transformation-health-systems-investment-priorities/

A Different Chemotherapy Approach for Ovarian Cancer

OVARIAN CANCER that spreads to the lining of the abdominal cavity, called the peritoneum, is difficult to treat. Patients with this advanced cancer typically undergo debulking, also called cytoreductive surgery, a lengthy procedure in which surgeons aim to remove all cancer from the abdominal cavity and affected organs, including the ovaries and fallopian tubes as well as the bladder, colon and other parts of the gastrointestinal tract. In recent years, researchers have looked at the efficacy of using hyperthermic intraperitoneal chemotherapy (HIPEC), which is heated chemotherapy delivered directly to the peritoneum, to destroy remaining cancer cells immediately after debulking surgery.

Scientists in Belgium and the Netherlands published long-term data from OVHIPEC-1, a randomized phase III trial to evaluate adding HIPEC to interval cytoreductive surgery for ovarian cancer, in the October 2023 Lancet Oncology. (In interval surgery, chemotherapy is given to shrink the cancer prior to surgery.) The study enrolled 245 women with stage III epithelial ovarian cancer whose cancer showed no signs of progression after upfront chemotherapy. Researchers randomly assigned women to have debulking surgery alone, or surgery plus HIPEC using the chemotherapy drug cisplatin. After 10 years, median overall survival for the surgery-plus-HIPEC group was 44.9 months versus 33.3 months for the surgery group. Median progression-free survival was 14.3 months and 10.7 months, respectively. The rates of adverse events were similar—25% with surgery alone versus 27% with surgery plus HIPEC—and the most common events were abdominal pain, infection and slowed bowel function.

These results are in line with the researchers’ five-year analysis, published in the New England Journal of Medicine in 2018. In that analysis, 6.6% of patients in the surgery group had survived without progression at five years, compared with 12.3% in the surgery-plus-HIPEC group. At 10 years, 6.6% of the people who received surgery were alive with no progression versus 10.1% in the surgery-plus-HIPEC group. While surgery plus HIPEC did not result in better cure rates, the authors note that it significantly prolonged the time cancer was controlled. “The most important finding is that the benefit for patients with stage III ovarian carcinoma when interval cytoreductive surgery is combined with HIPEC remains present after a 10-year follow up,” says Willemien van Driel, lead author and a gynecologic oncologist at the Netherlands Cancer Institute in Amsterdam, who notes that patients in both arms of the study received similar treatment after subsequent recurrences.

Van Driel says that there is still variation in the use of HIPEC along with cytoreductive surgery. European guidelines published in October 2023 note that HIPEC with cytoreductive surgery should not be considered a standard of care. In the U.S., National Comprehensive Cancer Network guidelines state that HIPEC can be considered for patients with stage III epithelial ovarian cancer.

Van Driel and her colleagues are now enrolling patients in the OVHIPEC-2 trial, which will study the effect of adding HIPEC in women with stage III ovarian cancer undergoing primary surgery, which is surgery done upfront prior to chemotherapy. Other trials are evaluating HIPEC use for recurrent ovarian cancer. She notes there are several unanswered questions, including optimal dosing and temperature for HIPEC and the impact of including other drugs, such as PARP inhibitors, with this approach, since many of these drugs were not standard of care at the time of the trial.

HIPEC may be a valid choice for patients who are generally healthy and open to a longer procedure and hospital stay. Although the length of surgery plus HIPEC varies, HIPEC generally adds 90 minutes or more to debulking surgery, which itself takes several hours. Also, patients typically require a longer hospital stay for recovery, possibly with intravenous or tube feedings while the digestive system recovers. 

Find more :

A Different Chemotherapy Approach for Ovarian Cancer

New evidence that brain and body health influence mental wellbeing

The study, published in Nature Mental Health, analysed UK Biobank data from more than 18,000 individuals. Of these, 7,749 people had no major clinically-diagnosed medical or mental health conditions, while 10,334 had reported a diagnosis of either schizophrenia, bipolar disorder, depression or anxiety.

Using advanced statistical models, the researchers found a significant association between poorer organ health and higher depressive symptoms, and that the brain plays an important role in linking body health and depression.

The organ systems studied included the lungs, muscles and bones, kidneys, liver, heart, and the metabolic and immune systems.

Dr Ye Ella Tian, lead author of the study from the Department of Psychiatry at the University of Melbourne, said. “Overall, we found multiple significant pathways through which poor organ health may lead to poor brain health, which may in turn lead to poor mental health.

“By integrating clinical data, brain imaging and a wide array of organ-specific biomarkers in a large population-based cohort, for the first time we were able to establish multiple pathways involving the brain as a mediating factor and through which poor physical health of body organ systems may lead to poor mental health.

“We identified modifiable lifestyle factors that can potentially lead to improved mental health through their impact on these specific organ systems and neurobiology.

“Our work provides a holistic characterisation of brain, body, lifestyle and mental health.”

Physical health was also taken into account, as well as lifestyle factors such as sleep quality, diet, exercise, smoking, and alcohol consumption.

Professor James Cole, an author of the study from UCL Computer Science, said: “While it’s well-known in healthcare that all the body’s organs and systems influence each other, it’s rarely reflected in research studies. So, it’s exciting to see these results, as it really emphases the value in combining measures from different parts of the body together.”

Professor Andrew Zalesky, an author of the study from the Departments of Psychiatry and Biomedical Engineering at the University of Melbourne, said. “This is a significant body of work because we have shown the link between physical health and depression and anxiety, and how that is partially influenced by individual changes in brain structure.

“Our results suggest that poor physical health across multiple organ systems, such as liver and heart, the immune system and muscles and bones, may lead to subsequent alterations in brain structure.

“These structural changes of the brain may lead to or exacerbate symptoms of depression and anxiety, as well as neuroticism.”

 

Find more : https://www.ucl.ac.uk/news/2024/aug/new-evidence-brain-and-body-health-influence-mental-wellbeing?utm_source=linkedin&utm_medium=social&utm_campaign=vpee_linkedin_newsletter&utm_content=bodyhealth_aug24

How to Find the Right Oncologist for You

After a cancer diagnosis, it’s one of the most important decisions you’ll make.

After a career as a golf professional in southeastern New Mexico, Doug Lyle, 76, decided he had somewhere better to be than on the course: spending time with his new grandchild. Then this summer, just as he was settling into retirement, he learned he had prostate cancer.

“When you’re first diagnosed, you immediately go to the internet, and you can be overwhelmed in short order,” he said. “The more you read about it, the more complicated it gets.”

One of the first and most important choices he had to make was who his oncologist would be. Many of the two million patients diagnosed with cancer in the United States each year get the news from a primary care doctor. Those patients might accept a referral to an oncologist without question. But research suggests that it’s worth considering the choice closely: It can shape the care you receive, your satisfaction with the treatment and your chances of survival.

Not everyone has a choice of oncologists. There are fewer providers in rural areas, and patients must travel farther to reach them. Insurers may only cover certain clinicians and hospitals. And patients from certain populations have less access to oncologists for a range of reasons, which may affect the care they receive. For example, research suggests that Black and Hispanic women with breast cancer are more likely than white women to experience delays in starting radiotherapy. And Black men with prostate cancer are less likely than white men to receive treatment that’s intended to cure their condition, even when they’re at similar stages of disease.

No matter your circumstances, you should feel empowered to have a say in who treats your cancer.

Ideally, experts said, you’d be able to easily compare doctors’ levels of experience and the outcomes of patients they’ve treated with your same diagnosis. But such apples-to-apples comparisons are not always easy to make. But “right now, there are no publicly available data to help a patient with cancer say, ‘Oh, this is where I want to go,’” said Dr. Nancy Keating, a physician and professor of health care policy and medicine at Harvard Medical School. (And even if there were, apples-to-apples comparisons are not always easy to make, since patient populations vary from one doctor to the next).

Still, there are some accreditations to look for. The National Cancer Institute has given a special designation to 72 cancer centers, which must show they treat patients in accordance with the latest evidence and also conduct research into new therapies. The American College of Surgeons Commission on Cancer has accredited over 1,500 programs that meet certain standards. And the American Society of Clinical Oncology has several certification programs, including a list of 300 practices recognized for their quality and safety.

There are resources to help you search for oncologists, too, including a U.S. News & World Report directory that lets you sort by location, patient reviews and accepted forms of insurance. The consumer research firm Castle Connolly also has a database of doctors who are nominated by their peers and then evaluated for their qualifications, interpersonal skills and more.

Look for an oncologist who frequently treats patients with diagnoses similar to yours. Research has long shown that when doctors perform certain procedures more often, their patients have better outcomes. One study found that patients of surgeons who removed more than 25 lung cancers a year spent less time in the hospital, had a lower risk of infection and were more likely to survive three years without recurrence of disease.

Dr. Timothy Pawlik, the chair of the surgery department at Ohio State University Wexner Medical Center, said he only treats a handful of cancers. “You want someone with depth, not breadth,” Dr. Pawlik said. That way, he explained, “the patient may have a rare cancer, but it’s not rare to that doctor.”

Additionally, everyone else on the care team including the anesthesiologists and nurses, will also be familiar with your particular cancer and treatment.

Your primary care provider may be able to find someone specializing in your diagnosis. Some physicians’ websites will identify sub-specialties, and you can also ask for guidance from patient advocacy groups focused on your type of cancer. When you reach out to a doctor, don’t be shy about asking how many patients with similar cancers they treat per year.

Mr. Lyle hesitated to get a second opinion for fear of offending the first doctor he’d seen. But he ultimately chose to do so, a step many experts recommend. “Medicine is an art, and there are sometimes differences of opinion,” said Karen Knudsen, the chief executive of the American Cancer Society. Weighing those differences can help you make a more informed choice.

If a second physician agrees with your original treatment plan, it can give you more confidence in the approach. Research suggests a second opinion can also lead to clinically meaningful changes in treatment. One 2023 study of 120 cancer patients found that a for a third of patients, a second opinion led to treatment changes that yielded better outcomes. Many had received evidence-based care from their first doctor but decided after a second opinion to scale back treatments that might have been unnecessary and had harmful side effects.

Mr. Lyle said that during his first conversation with a physician, he didn’t know enough to ask the right questions about his diagnosis and newer treatment options. “The fine points, you’re not aware of yet. So you almost need a rehearsal,” he said. (For help with what to ask during an appointment, the National Comprehensive Cancer Network has detailed information about care for many cancers.)

When it is clinically appropriate, some cancer centers now offer second opinions through telehealth. You can call to see if it’s possible to submit your medical records and get a remote consultation.

Find more:

What to Know About the HPV Vaccine and Cancer Prevention

New research shows many eligible people are not getting the shots.

Nearly 20 years after the first vaccine against human papillomavirus became available, many eligible Americans still are not getting the shot — even though it provides powerful protection against the leading cause of cervical cancer and a strong risk factor for anal cancer.
HPV is the most common sexually transmitted infection in the United States, and while most infections are asymptomatic and clear up on their own within two years, a small number persist and can cause cancer. HPV causes nearly all cases of cervical cancer, and can also lead to penile, anal, oral, vulvar and vaginal cancers.

The HPV vaccine, delivered as two or three doses, can significantly cut the risk of infection. It “is really one of the most effective vaccines we have,” said Dr. Lauri Markowitz, the HPV team lead in the Centers for Disease Control and Prevention’s division of viral diseases. But uptake remains stubbornly low: A report released by the C.D.C. this month showed that in 2022, only 38.6 percent of children ages 9 to 17 had received at least one dose of the HPV vaccine. Other new research suggests that HPV vaccination rates stalled in the wake of the coronavirus pandemic.

A study published this week laid out some of the primary reasons cited by parents in the United States who don’t plan to vaccinate their children against HPV, including safety concerns, a lack of knowledge about the vaccine and a belief that it isn’t necessary.
“We are still facing an uphill battle from what I would call inappropriate messaging or incomplete messaging when the vaccine rolled out about why this is so important,” said Karen Knudsen, chief executive of the American Cancer Society.

The HPV vaccine fools the body into thinking it has come into contact with the virus, marshaling antibodies in defense. Those antibodies can help clear the virus and prevent infection if someone is later exposed, which can happen through oral, anal and vaginal sex.

The vaccine offers protection from the types most likely to cause cervical and anal cancers and genital warts. Since the vaccine was introduced in 2006, infections with the types of HPV that cause most HPV-related cancers and genital warts have fallen by 88 percent among teen girls and by 81 percent among young adult women, according to the C.D.C.
One reason doctors are so enthusiastic about the vaccine is that it is one of very few tools to combat HPV: Condoms do not entirely prevent transmission, and there is no treatment for the virus itself. Researchers believe HPV is responsible for more than 90 percent of cervical and anal cancers and a majority of vaginal, vulvar, and penile cancers.

Children can be vaccinated starting at age nine. The C.D.C. recommends the vaccine for all preteens from the age of 11 or 12 and anyone up to age 26. It’s most effective before people are exposed to the virus, and “the assumption is that most people have started having sexual intercourse by age 26,” said Dr. Ban Mishu Allos, an associate professor of medicine at Vanderbilt University Medical Center.

The vaccine may still provide some benefit for people over age 26, and is approved up until age 45. The C.D.C. says that people between the ages of 27 and 45 might get the vaccine after talking to their doctors about their risk for new HPV infections.

You can ask your primary care doctor or local health centers for the vaccine. Most insurance plans fully cover it through age 26. Children and adolescents who are uninsured or underinsured can get the shots for free through the Vaccines for Children program. After age 26, insurance may not fully cover the shot, which can cost hundreds of dollars per dose. Merck, which makes the HPV vaccine Gardasil 9, has a patient assistance program for eligible people.

Researchers believe much of the hesitation stems from a key misunderstanding: “More people perceive it as a sexually transmitted infection prevention vaccine, as opposed to a cancer prevention vaccine,” said Kalyani Sonawane, an associate professor of public health sciences at the M.U.S.C. Hollings Cancer Center and an author of the new paper on parental attitudes toward HPV vaccination.

Dr. Sonawane’s research has also found that many parents are concerned about side effects. But doctors say many people do not experience side effects, and for those that do, the issues are generally mild and can include arm soreness, nausea, dizziness or, in some cases, fainting.

Doctors urge parents to vaccinate their children before they’re likely to become sexually active, which gives some parents pause, said Dr. Monica Woll Rosen, an obstetrician-gynecologist at the University of Michigan Medical School.

“You’re doing something to prevent them from getting cancer in 30 years,” she said, “and the disconnect might be too large for some people to really wrap their heads around.”

 

Find more : https://www.nytimes.com/2024/02/22/well/live/hpv-vaccine-cancer.html

Ending financial discrimination for cancer survivors: embedding the Right to be Forgotten in legislation across Europe

A new study published today in The Lancet Oncology highlights that many of the current 20 million cancer survivors across Europe are being discriminated against in accessing financial services, including loans, mortgages, health and travel insurance.

The work indicated that on average, up to 25% of those living beyond their cancer may be having more difficulty accessing appropriate financial services.

A European-wide effort is currently attempting to fight this discrimination, by supporting the introduction of legislation that will permit successfully treated cancer patients to not declare a previously diagnosed cancer, so that their diagnosis is essentially “forgotten”.
In January 2016, France became the first country in the world to introduce the “Right To Be Forgotten”, specifying that long-term cancer survivors do not have to share medical information with a financial institution about their cancer diagnosis after a delay of five years without recurrence. Seven other European countries have since taken similar legal measures to counter financial discrimination against cancer survivors. Other European Member States have chosen to implement self-regulatory codes of conduct (Denmark, Finland, Greece, Ireland, Luxembourg), but these are not legally binding.

With over eight years of experience, evidence from France indicates no significant negative impact on insurance companies operating in the French jurisdiction.

Those who are living beyond their disease should not be penalised for a previous cancer diagnosis. Cancer patients across Europe who have been successfully treated should, by law, be able to avoid disclosing a previous diagnosis of cancer, so that they can access the financial services that they need.

Professor Lawler added: “This is not about compassion; this is about evidence and acting on that evidence. When a cancer professional says that you are cured and international benchmarking agrees, then why do the financial institutions say that you are not? Don’t make cancer patients pay twice. Ensure the Right To Be Forgotten is enshrined in law throughout Europe.”

Read the full study here: https://lnkd.in/e_PZHn_j

It’s never been more important to focus on cancer prevention

With an ageing population, cancer cases predicted to increase from 17 million to 30 million by 2040 and rising levels of overweight and obesity, it’s never been more important to focus on cancer prevention. Over 40% of cancers could be prevented if we all lived healthy lifestyles, including maintaining a healthy weight, being physically active and eating a healthy diet.

But what does this mean in practice? Every day we’re bombarded with information about what’s healthy and what isn’t. It can be confusing and seem contradictory: what’s missing is the context – how do all the disparate pieces fit together to make a coherent picture?

That’s where our Global Cancer Update Programme, formerly known as the Continuous Update Project, comes in. This huge undertaking pulls the puzzle pieces together to show how what we eat, what we weigh and how active we are all affect our risk of cancer. The Expert Paneloverseeing the process then use that information to develop Recommendations for Cancer Prevention.

A while back I wrote about how this work was moving into a new and exciting phase of development. This new phase has now started and the programme has changed in a number of ways. It’s more:

  • targeted – looking at specific research questions such as early life exposures and their impact on cancer risk later in life.
  • collaborative – to increase the reach and scope of the work a number of collaborations with leading international research groups will take place that focus on specific areas such as dietary patterns and the life course.
  • efficient – we are shifting from reviewing all risk factors for every cancer to systematically scanning the evidence to identify which topics are likely to be the most fruitful areas of detailed study. Integrating more automation into the review process will be central to this.
  • inclusive – in addition to looking at cancer prevention, the work will expand to encompass cancer survivors. With improved diagnosis and treatment the good news is that there is a growing population of people living with and beyond cancer. The Global Cancer Update Programme will help us to understand how diet, nutrition and physical activity can improve long-term health and prolong survival after a cancer diagnosis.

There are four major themes to the work:

1. Cancer incidence

Looking at how a wide range of factors relating to diet, nutrition and physical activity as well as patterns of diet and lifestyle can affect cancer risk – either through decreasing risk or increasing it.

2. Cancer survivors

Focusing on the impact of diet, nutrition and physical activity on long-term health (cancer and non-cancer related morbidity, mortality and quality of life) after a cancer diagnosis. As part of this, we will look to determine for the first time the impact of diet, nutrition and physical activity on childhood cancer survivors.

3. Cancer mechanisms

Understanding the biological processes that underpin the links between diet, nutrition and physical activity and cancer.

4. Obesity

Ensuring previous work in relation to overweight and obesity remains up to date, given its critical role in increasing the risk of many cancer types. In addition, we will explore whether more specific guidance can be made for preventing obesity in adulthood and early life.

This comprehensive programme of work will allow us to look more deeply at how diet, nutrition and physical activity affect cancer risk and survival. In the next few years, the Global Cancer Update Programme will enable a more sophisticated understanding, with a more personalised approach to cancer prevention and survival than ever before.

Find out more about our Global Cancer Update Programme

Nearly half of adult cancer deaths in the US could be prevented by making lifestyle changes, study finds

About 40% of new cancer cases among adults ages 30 and older in the United States — and nearly half of deaths — could be attributed to preventable risk factors, according to a new study from the American Cancer Society.

“These are things that people can practically change how they live every single day to reduce their risk of cancer,” said Dr. Arif Kamal, chief patient officer with the American Cancer Society.

Smoking was the leading risk factor by far, the study found, contributing to nearly 1 in 5 cancer cases and nearly a third of cancer deaths. Other key risk factors included excess body weight, alcohol consumption, physical inactivity, diet and infections such as HPV.

Overall, researchers analyzed 18 modifiable risk factors across 30 types of cancer. In 2019, these lifestyle factors were linked to more than 700,000 new cancer cases and more than 262,000 deaths, the study found.

Cancer grows because of DNA damage or because it has a fuel source, Kamal said. Other things — such as genetics or environmental factors — can also create these biological conditions, but modifiable risks explain a significantly larger share of cancer cases and deaths than any other known factors. Exposure to sunlight can damage DNA and lead to skin cancer, for example, while fat cells produce hormones that can feed certain cancers.

“With cancer, it oftentimes feels like you have no control,” Kamal said. “People think about bad luck or bad genetics, but people need to feel a sense of control and agency.”

Certain cancers are more preventable than others, the new study suggests. But modifiable risk factors contributed to more than half of new cases for 19 of the 30 types of cancer evaluated.

There were 10 types of cancer where modifiable risk factors could be attributed to at least 80% of new cases, including more than 90% of melanoma cases linked to ultraviolet radiation and nearly all cases of cervical cancer linked to HPV infection, which can be prevented with a vaccine.

Lung cancer had the largest number of cases attributable to modifiable risk factors — more than 104,000 cases among men and 97,000 among women — and the vast majority were linked to smoking.

After smoking, excess body weight was the second largest contributor to cancer cases, linked to about 5% of new cases in men and nearly 11% of cases in women. It was associated with more than a third of deaths from cancer of the endometrium, gallbladder, esophagus, liver and kidney, the new study found.

Another recent study found that the risk for certain cancers was significantly reduced for people taking popular weight-loss and diabetes medications such as Ozempic and Wegovy.

“Obesity is emerging, in some ways, as just as potent of a risk for people as smoking is,” said Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials. He was not involved in the new study, but has prior experience working on cancer prevention initiatives.

Intervening on a set of “core behavioral risk factors” — quitting smoking, eating well and exercising, for example — can make a “dramatic difference in the rates and outcomes of chronic diseases,” Plescia said. And cancer is one of those chronic diseases, just like heart disease or diabetes.

Policymakers and health officials should work to “create environments where it’s easier for people, where the healthy choice is the easy choice,” he said. And it’s particularly important for people who are living in historically disadvantaged neighborhoods, where it might not be safe to exercise or easy to get to a store with healthy food.

As rates of early-onset cancer rise in the US, it’s especially important to create healthy habits early, experts say. It’s harder to quit smoking once you’ve started or lose weight that you’ve gained.

But “it’s never too late to make these changes,” Plescia said. “Turning (health behaviors) around later in life can make a profound difference.”

And making lifestyle changes to minimize exposure to certain factors can reduce cancer risk relatively quickly, experts say.

“Cancer is something your body fights every single day as your cells divide,” Kamal said. “It’s a risk that you face every day, and that also means that the reduction of the risks can benefit you every day as well.”

READ MORE :

https://edition.cnn.com/2024/07/11/health/cancer-cases-deaths-preventable-factors-wellness/index.html?utm_source=salesforce-marketing-cloud&utm_medium=email&utm_campaign=July+23%2c+2024+Cancer+Today+eNewsletter&utm_term=Read+More+in+Cancer+Today

Cancer is on the rise in under-50s – a key task is to work out why

Nine in 10 of all cancers affect people over 50 but research shows a worrying rise in early onset cases

There are many upsides to growing old, but one of the downsides, unfortunately, is a higher risk of developing cancer. Increasing age is a key risk factor. And with more of us living longer worldwide, millions of older people will have to contend with the disease

Now a new study adds weight to previous work warning of a grim trend in global health: cancer in people under the age of 50 is becoming more common.

In the study, researchers led by the University of Edinburgh in Scotland and Zhejiang University School of Medicine in Hangzhou, China, found that the number of under-50s being diagnosed with cancer worldwide rose by 79% between 1990 and 2019, from 1.82 million to 3.26 million. Cancer deaths in the same age group grew by 27%, and more than 1 million under-50s a year are now dying of cancer, the research published in BMJ Oncology reveals

The study is not the first to show the trend. A review in 2022 of cancer registry records from 44 countries found that the incidence of early onset cancer was rising rapidly for 14 types of cancers, and this increase was happening across many middle- and high-income nations.

The new research adds meat to the bone. Examining data from 204 countries, it found a striking increase in the global incidence of early onset cancers. It also showed the highest incidence rates of cancer in the under-50s was in North America, Oceania and western Europe.

Researchers worldwide are only just starting their next task: working out why.

The authors of the 2022 review, led by Harvard University, said any uptick in testing or checks could not account for the rise in diagnoses. They suggested the rise was most likely due to an unhealthy mix of risk factors that could be working together, some which are known and others of which need to be investigated.

Many of these risks had established links to cancer such as obesity, inactivity, diabetes, alcohol, smoking, environmental pollution and western diets high in red meat and added sugars, not to mention shift work and lack of sleep. Experts have speculated that ultra-processed food may also be partly to blame

The researchers behind the new study echoed those observations. Genetic factors are likely to have a role, they say. But diets high in red meat and salt and low in fruit and milk, as well as alcohol consumption and tobacco use, are the main risk factors underlying the most common cancers among under-50s, with physical inactivity, excess weight and high blood sugar other contributory factors.

As worrying as the increase in early onset cancers is, caution is required. Cancer in people under 50 is still uncommon. With breast cancer, the most common type in under-50s, there were 13.7 cases per 100,000 people in 2019. Nine in 10 of all cancers affect people over 50.

Until experts unlock definitive answers, there remains plenty that people young and old can do to reduce their risk of cancer. Not smoking, maintaining a balanced diet and a healthy weight, getting plenty of exercise and staying safe in the sun are among them.

 

Andrew GregoryHealth editor

https://www.theguardian.com/science/2023/sep/05/cancer-is-on-the-rise-in-under-50s-a-key-task-is-to-work-out-why?utm_source=salesforce-marketing-cloud&utm_medium=email&utm_campaign=September+12+2023+Cancer+Today+E-newsletter&utm_term=Read+More+in+the+Guardian

Digital-in-Health: Unlocking the Value for Everyone

Digital technology can strengthen health systems, improve health financing and public health, and increase reach to underserved populations, according to a new World Bank report launched today. The report also finds that digital technology and data are especially helpful to prevent and manage chronic diseases, care for both young and aging populations, and prepare for future health emergencies and health risks triggered by climate change.

The report, Digital-in-Health: Unlocking the Value for Everyone, was launched today during the G20 Health Ministers Meeting in Gandhinagar, India. It presents a new way of thinking from simple digitization of health data to fully integrating digital technology in health systems: Digital-in-health. This means, for example, infusing digital technologies in health financing, service delivery, diagnostics, medical education, pandemic preparedness, climate and health efforts, nutrition, and aging.

The report also underscores that the successful use of digital technologies must be inclusive of all population groups, and ensure access to digital infrastructure, modern technologies, and skills, especially for vulnerable people.

“Designed with people at the center, digital technology can make health services more personal, prevent healthcare costs from increasing, reduce differences in care, and make the job easier for those who provide health services,” said Mamta Murthi, Vice President for Human Development, World Bank. “We hope that this report will give governments confidence and practical guidance, regardless of the country’s stage of digital maturity or fiscal challenges.”

Improving health is getting harder, not easier. Health systems face serious and growing challenges and policy decisions are too often not based on reliable data.  It is estimated that some countries use less than 5% of health data to improve health which means that decisions are not based on data or data is not used effectively to make improvements. Within challenging fiscal environments, people-centered and evidence-based digital investments can help governments save up to 15% of health costs. The report presents pragmatic, low-cost actions to improve digital-in-health, no matter the maturity of a country’s systems or digital infrastructure. For example, better health data governance and standards to ensure systems can readily connect and exchange information are not costly but will be game changing in reducing siloed digital solutions and fragmentation.

“In India, we have shown that digital innovations such as tele-consultations have reached more than 140 million people and provided accessible, affordable and efficient healthcare for everyone,” said Mansukh L Mandaviya, Minister for Health and Family Welfare, India. “We believe a digital-in-health approach can unlock the value of digital technologies and data and has the potential to prevent disease and lower healthcare costs while helping patients monitor and manage chronic conditions.” 

 

To help countries embrace a digital-in-health approach, the report proposes three essential areas to guide investments:

  1. Prioritizeevidence-based digital investments that tackle the biggest problems and focus on the needs of patients and providers.
  2. Connect the regulatory, governance, information, and infrastructure dots so that patients know that data is safe and health workers can use digital solutions transparently.
  3. Scale digital health for the long run based on trust with sustainable financing, and improved capacity and skills for digital solutions.

It will take global, regional, and country leadership to make digital-in-health a reality. The report recommends strong country leadership involving all relevant sectors and stakeholders, including civil society. Digital technology and data improvements will involve investments beyond the health sector and new partnerships with the private sector. A digital-in-health mindset needs to be a routine aspect of annual health system planning, budgeting, and implementation.

The World Bank is committed to helping low-and middle-income countries to make digital-in-health a reality to improve health for everyone. Over the past decade, the World Bank has invested almost $4 billion in digital health including in health information systems, digital governance, identification systems, and infrastructure.

For more information, including a copy of the new report, Digital-in-Health: Unlocking the Value for Everyone, please visit:

Website: www.worldbank.org/en/topic/health

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YouTube: http://www.youtube.com/worldbank