Category: DATA

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

Stem Cell Therapy: A New Horizon in Breast Cancer Treatment

Breast cancer is one of the most common cancers affecting women worldwide, with millions of new cases diagnosed each year. Despite advances in treatment, it remains a leading cause of cancer-related deaths among women. Traditional treatments such as surgery, chemotherapy, and radiation have improved survival rates, but they often come with significant side effects and may not be effective in all cases, particularly in advanced or metastatic stages of the disease. As the medical community continues to seek more effective and less invasive treatments, stem cell therapy is emerging as a promising frontier in the fight against breast cancer.

Understanding Breast Cancer: A Global Challenge

Breast cancer occurs when cells in the breast tissue grow uncontrollably, forming a tumor that can invade surrounding tissues and spread to other parts of the body. The causes of breast cancer are multifactorial, involving genetic, environmental, and lifestyle factors. Early detection through screening programs like mammography has significantly improved outcomes, but the need for more effective treatments remains critical, especially for patients with aggressive or resistant forms of the disease.

Traditional treatments, while often life-saving, can have significant drawbacks. Surgery can be disfiguring and may not completely eliminate the risk of recurrence. Chemotherapy and radiation, although effective at killing cancer cells, also damage healthy cells, leading to side effects like fatigue, hair loss, and compromised immune function. Moreover, some breast cancers do not respond well to these treatments, particularly triple-negative breast cancer, which lacks the hormone receptors targeted by many therapies.

This is where stem cell therapy comes into play—a novel approach that has the potential to revolutionize breast cancer treatment.

Stem Cell Therapy: A New Horizon in Breast Cancer Treatment

Stem cell therapy has garnered significant attention in recent years as a potential game-changer in cancer treatment. Unlike traditional therapies that target the symptoms or manifestations of the disease, stem cell therapy aims to address the underlying causes by regenerating damaged tissues, boosting the immune system, and even targeting cancer stem cells that are believed to drive tumor growth and recurrence.

1. Understanding Stem Cells:

  • Stem cells are unique in their ability to develop into different types of cells in the body. They have the potential to repair or replace damaged tissues and can be used to regenerate healthy tissue in areas affected by cancer.
  • There are two primary types of stem cells relevant to cancer therapy: embryonic stem cells, which can differentiate into any cell type, and adult stem cells, which are more limited but still hold significant therapeutic potential. In breast cancer, researchers are particularly interested in the role of cancer stem cells— a small subset of cells within tumors that are resistant to conventional treatments and are thought to be responsible for relapse and metastasis.

2. The Role of Stem Cells in Breast Cancer:

  • One of the most promising aspects of stem cell therapy in breast cancer is its potential to target cancer stem cells. These cells are thought to be the root cause of tumor growth and metastasis, and they often evade traditional therapies, leading to recurrence. By specifically targeting and eliminating these cells, stem cell therapy could significantly reduce the risk of relapse and improve long-term outcomes.
  • Additionally, stem cell therapy can be used to regenerate healthy tissue damaged by surgery, chemotherapy, or radiation. For example, adipose-derived stem cells (from fat tissue) are being explored for their ability to repair tissue damage after a mastectomy or lumpectomy, improving cosmetic outcomes and reducing the need for additional surgeries.

3. Current Research and Clinical Trials:

  • While stem cell therapy for breast cancer is still in its early stages, there have been promising developments in both preclinical and clinical research. Clinical trials are currently underway to evaluate the safety and efficacy of various stem cell-based therapies for breast cancer.
  • One area of focus is the use of mesenchymal stem cells (MSCs), which have shown potential in targeting breast cancer cells and enhancing the effects of chemotherapy. These stem cells can be engineered to deliver anti-cancer drugs directly to tumors, increasing the precision and effectiveness of treatment while minimizing side effects.
  • Another exciting avenue is the use of stem cells in combination with immunotherapy. By enhancing the body’s immune response to cancer, stem cells could help to overcome the immune evasion tactics used by tumors, making immunotherapy more effective.

4. Challenges and Future Directions:

  • Despite the promise of stem cell therapy, there are still significant challenges to overcome. Ensuring the safety of these therapies is paramount, as there is a risk that stem cells could promote tumor growth if not properly controlled. Moreover, the complex nature of cancer stem cells means that therapies must be precisely targeted to avoid unintended consequences.
  • The future of stem cell therapy in breast cancer will likely involve a combination of approaches, integrating stem cells with existing treatments such as chemotherapy, radiation, and immunotherapy. As our understanding of cancer biology continues to grow, so too will the potential of stem cell therapy to provide more effective and less toxic treatment options for breast cancer patients.

    Conclusion: A Promising Future Ahead

    The fight against breast cancer is far from over, but the advent of stem cell therapy offers a new ray of hope. As research continues to advance, this innovative approach could become a cornerstone of breast cancer treatment, offering patients more effective, personalized, and less invasive options. While challenges remain, the potential of stem cell therapy to transform breast cancer care is undeniable, and the ongoing research in this field is something that the medical community and patients alike should watch closely.

    As we move forward, it is essential to continue supporting research and clinical trials that explore the full potential of stem cell therapy in breast cancer. With continued innovation and collaboration, we may one day see a world where breast cancer is not only treatable but curable—thanks in part to the incredible power of stem cells.

    Find more : https://www.linkedin.com/company/medipocketusa/posts/?feedView=all

Transforming Healthcare: The Power of Timely Information and Exercise in Underserved Communities

In today’s rapidly evolving world, having the right information at the right moment can determine success or failure, health or illness. As professionals, we recognize the critical impact of timely information, especially in health and wellness. It’s imperative to leverage this knowledge and take decisive action, particularly to support underserved communities.

Access to Healthcare: An Ongoing Challenge

Despite technological advancements, timely access to healthcare information remains a significant challenge in America. Disparities in healthcare access lead to varying health outcomes across different populations. Underserved communities often face systemic barriers that hinder their ability to receive prompt and adequate healthcare.

The consequences are evident: delays in health screenings, diagnostics, and treatments exacerbate conditions that could be manageable or preventable. This results in higher rates of chronic diseases like diabetes and hypertension among marginalized groups. The American Heart Association reports that African Americans are nearly twice as likely to have diabetes compared to non-Hispanic whites. These delays perpetuate cycles of poor health and reduced quality of life.

Exercise is Medicine: A Call to Action

The CDC’s extensive research underscores the benefits of regular physical activity. Our task is to ensure that underserved communities can access and utilize this powerful tool. The focus is on making fitness accessible to everyone, regardless of their circumstances.

Healthcare providers, fitness professionals, and community leaders must disseminate accurate and actionable information about exercise, empowering individuals to make healthier choices. It’s about promoting physical activity and breaking down barriers to make fitness accessible to all.

A Successful Example: HEALTHEFIT DWF in Covington, GA

HEALTHEFIT DWF in Covington, GA, exemplifies how integrating Exercise is Medicine (EIM) and Remote Therapeutic Monitoring (RTM) can revolutionize healthcare delivery in underserved communities. As a trusted advisor from its inception, I have seen firsthand how their innovative Medical Fitness Therapy program significantly enhances patient care.

Patients at HEALTHEFIT DWF benefit from real-time updates and personalized recommendations delivered via advanced digital platforms. This seamless integration of technology into healthcare management allows for easier chronic condition management and better adherence to treatment plans.

The success of HEALTHEFIT DWF is built on several key elements, including:

  • Integration of Cutting-Edge Technologies – HEALTHEFIT DWF uses advanced digital health solutions for continuous patient monitoring. These platforms collect and analyze data on vital signs, physical activity, and other health indicators, enabling prompt responses to emerging health issues.
  • Personalized Health Plans – Patients receive tailored health plans with specific exercise regimens, dietary recommendations, and lifestyle modifications, continuously updated based on real-time data and progress to meet their unique health needs and goals.
  • Enhanced Patient Engagement – Digital platforms have improved patient engagement by providing access to health data and facilitating easy communication with healthcare providers. This transparency fosters ownership and active participation in treatment plans.
  • Community Outreach and Education – HEALTHEFIT DWF emphasizes community outreach and education through regular workshops and seminars on exercise and healthy living, empowering individuals to take proactive steps towards better health.
  • Collaboration with Healthcare Professionals – The success of HEALTHEFIT DWF stems from collaboration between fitness professionals and healthcare providers, ensuring comprehensive care that addresses both medical and fitness needs, enhancing overall treatment effectiveness.
  • Measurable Health Outcomes – HEALTHEFIT DWF’s approach has led to measurable improvements in managing chronic conditions such as diabetes, hypertension, and obesity. Timely health information and personalized care plans have resulted in better health outcomes and quality of life.

Conclusion: Information and Exercise as Catalysts for Change

The challenges in healthcare access underscore the transformative power of timely information and the promotion of exercise as medicine. Whether delivering health advice or emphasizing the benefits of physical activity, receiving the right information at the right time is crucial for individual and collective well-being.

The example of HEALTHEFIT DWF in Covington, GA, illustrates how integrating EIM and RTM can revolutionize healthcare delivery, particularly in underserved communities. Their proactive approach, leveraging cutting-edge technology and personalized care, has led to significant health improvements for their patients. This model provides valuable insights and a blueprint for future healthcare initiatives aiming to bridge the gap in healthcare access and outcomes.

As we reflect on our progress and future goals, let us commit to ensuring that everyone has access to the information they need for a healthy and fulfilling life. By prioritizing timely and equitable access to healthcare information—especially regarding exercise as medicine and RTM—we can advance toward a healthier and more just society.

This is our call to duty. Let’s remain vigilant in our pursuit of timely information and accessible exercise opportunities, understanding that these are not just conveniences but fundamental rights that can unlock freedom, health, and opportunity for all.

References:

  • American Heart Association. “African Americans & Cardiovascular Diseases.” Retrieved from heart.org.
  • Centers for Disease Control and Prevention. “Physical Activity and Health.” Retrieved from cdc.gov.

David Rachal III, MBA, EIM-C, MFP-C, is a Medical Fitness Practitioner with decades of experience in chronic disease management and preventive solutions. David is dedicated to integrating digital health solutions into traditional healthcare practices to enhance patient outcomes and promote a healthier lifestyle. He has been instrumental in the start-up phases of DWF Wellness in Covington, GA, and continues to serve as a trusted advisor.

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Transforming Healthcare: The Power of Timely Information and Exercise in Underserved Communities

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

Commercial determinants of health: how they are driving up rates of cancer and other NCDs

A new report from the WHO Regional Office for Europe looks at the impacts of the commercial determinants of health

Tobacco, alcohol, highly processed foods and fossil fuel industries cause 19 million deaths per year globally. These shocking statistics, reported in Commercial Determinants of noncommunicable diseases in the WHO European Region, show how commercial activities are harming our health and increasing the global burden of non-communicable diseases (NCDs), including cancer (WCRF International contributed to two case studies to this report, one on civil society engagement and one on alcohol warning labels).

The commercial determinants of health (CDOH) assess how commercial industries and their products can influence and impact the overall health and health equity of people, and whole societies.

Impacts of CDOH are felt across society, from the individual consumer, their health behaviours and choices, extending to global levels of consumption, and the politics and economics of increasing globalisation.

Health-harming industries

Commercial determinants that negatively impact health involve products from unhealthy commodity industries, which produce and sell health-harming products such as:

  • tobacco
  • alcohol
  • highly processed foods
  • and fossil fuels

The recent WHO/Europe report shows how exposure to these health-harming products is driving up already exceptionally high rates of cancer and other NCDs globally.

In the European Region alone, almost two thirds (61.3%) of deaths caused by NCDs can be attributed directly to risk factors linked to unhealthy diets, physical inactivity, alcohol and tobacco consumption.

This equates to an estimated 2.7m deaths annually, or more than 7,400 deaths every day. Many of these deaths could be prevented with reduced exposure to these commercial products.

Corporate channels of influence

You will certainly have experienced commercial forces at play in the world in both visible and invisible ways. Industries influence and impact health, and undermine policymaking through the following corporate channels:

  • marketing and advertising
  • engaging in corporate social responsibility strategies and activities
  • lobbying governments and policymakers; and
  • deflecting attention away from their role and responsibilities in causing health harms

Marketing and advertising enhance the acceptability and desirability of health-harming products. Often selling a certain lifestyle, aesthetic or experience, it normalises these products as part of everyday life, as well as more aspirational ways of living.

Marketing and promotions have been found to disproportionately target low socioeconomic status or minority populations, with industry tactics ranging from timing marketing campaigns to coincide with the distribution of benefits from food assistance programmes, to aiming advertisements directly at children.

Corporate social responsibility activities serve to improve corporate brands and reputations. Coca-Cola or PepsiCo’s frequent sponsorship of sports teams, events, and funding children’s physical activity programmes seeks to shift focus away from how their own products contribute to the obesity epidemic, and instead reflect favourably on their support for physical activity promotion.

DrinkAware, an alcohol-industry funded health information organisation, promotes “responsible drinking” campaigns (despite alcohol being classified as a Group 1 carcinogen that is causally linked to 7 types of cancer), and engages in partnerships with government and public health agencies.

Lobbying governments and policymakers works to avoid or circumvent regulation. Examples include the food and beverage industry’s opposition to sugar-sweetened beverage taxes, or the alcohol industry’s use of legal threats to stop the implementation of health warning labels.

Public health experts are also targeted through less obvious channels, such as Coca-Cola’s emails to the US Centre for Disease Control (obtained through Freedom of Information Act requests) to advance corporate objectives over health, including trying to influence the WHO.

Other tactics include funding research and political parties to sway the evidence base and policymakers in their favour—influencing all levels of policy, from scientific evidence through to policy development and implementation.

Where does the buck stop?

Perhaps the most significant and insidious tactic used by health-harming industries is their deflection of responsibility. Industry uses the rhetoric of ‘personal responsibility’, ‘individual’ or ‘freedom of choice’ around the consumption of their products.

These messages shift the blame away from health-harming industries, and onto their customers. This argument is used not only to shape societal views around consuming tobacco, alcohol and unhealthy foods, but also in legal arguments to deny or downplay their responsibility and liability for the costs they impose on society.

Do not be mistaken: these efforts are intentionally well-crafted and funded. Health-harming industries seek to protect their own interests and offload their responsibility at the expense of public health. These narratives serve to manufacture doubt and increase uncertainty in the public, while simultaneously undermining trust in government agencies and scientific evidence to normalise the prevalence and use of their products.

Is addressing commercial determinants of health anti-business?

It’s also important to recognise what addressing CDOH is not. Addressing CDOH is not anti-business; but rather, it challenges the existing status quo and power imbalances. It also does not assume a solely negative impact: it accounts for industry actors to drive health and equity in either direction.

Profitable business and health promotion do not need to be mutually exclusive. For example, a coalition of Nestlé shareholders (co-ordinated by Share Action) has filed a resolution to challenge the company to increase their proportion of sales from healthier products.

Work to address CDOH is also not an attack on the free market, or personal liberties. It is about a consumer’s right to know about the risks involved with consuming a harmful product.

Say for instance you had a higher risk of developing breast cancer. Would knowing that drinking alcohol increases your risk of developing it, or 6 other types of cancer, impact whether you decide to consume alcohol? When buying products, would you want to be thoroughly informed about the risks you take?

Interestingly, critics of responses aimed to address CDOH often (knowingly or unknowingly) follow the same script taken straight from health-harming industries’ playbook.

This upholds the narrative that responsibility solely rests with the individual and does not hold corporations accountable for the health impacts of their products, or their influence through the four corporate channels.

Getting rid of the industry playbook; reframing the issues

But this criticism is misplaced: rather than effecting a ‘nanny-state’ or ‘prohibition’, addressing CDOH is an act to abolish and break free from the false-narratives and manipulation that industries employ for their own profit and gains.

Given the scale and size of transnational corporations, some with incomes higher than GDPs of whole countries, putting a focus on the CDOH and their impacts will have a global effect.

This is a movement to shift the focus and alignment of political will in a direction that better serves public health and health outcomes, including the reduction of health inequities, and incidence of cancer and other NCDs.

For more information on CDOH
> WHO Europe Report Commercial Determinants of noncommunicable diseases in the WHO European Region – the report also contains a number of case studies, which WCRF International has contributed to.

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.”

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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

What Is a Cancer Vaccine?

When you hear the word “vaccine,” you might think of your annual flu shot or COVID booster, but did you know that some vaccines can treat—or even prevent—cancer?

But before we get there, let’s start with the basics—what is a vaccine? How does it protect you from disease?

A vaccine at its core delivers something associated with disease, such as a protein, into your body, which trains your immune system to recognize and react to the disease later on.

Think of it as training a dog on a specific scent.

Flu vaccines, for example, deliver pieces of a protein from the flu virus. Your immune system sees the protein, recognizes that it doesn’t belong in your body, mounts an immune response against it, and stores this information in its “memory.”

Now that your immune system has been trained to respond to this flu protein, it will be ready to attack if you later are infected with the flu, allowing it to rapidly get rid of the virus before it has a chance to make you sick.

CAN VACCINES PREVENT CANCER?

Yes! Several vaccines protect against human papillomavirus (HPV), the most common cause of cervical cancer and a major cause of anal, oral, throat, and genital cancers. By preventing HPV infection, these vaccines also prevent the cancer-causing changes induced by HPV.

The first HPV vaccine was approved by the U.S. Food and Drug Administration (FDA) in 2006, and since that time, the rate of cervical cancers has dropped significantly among people who were vaccinated as adolescents.

The Center for Disease Control (CDC) recommends HPV vaccines for all adolescents (boys and girls) beginning at age 11 or 12 and up to age 26 for those who didn’t receive them earlier. Some people might be eligible for the vaccine after age 26 as well.

HOW DO VACCINES TREAT CANCER?

The vaccines we’ve discussed so far are preventive vaccines—they help people avoid a particular disease. Other vaccines, known as therapeutic vaccines, are instead used to treat patients already diagnosed.

Therapeutic vaccines for cancer work in the same way as preventive vaccines: biological material is injected into the patient, where it trains the immune system to find and attack disease, cancer in this case.

To date, only one targeted therapeutic cancer vaccine has been approved by the FDA, but researchers have continued to develop and test different types of cancer vaccines, with many of these showing recent promise against hard-to-treat cancers.

Unlike vaccines that target viruses, therapeutic vaccines for cancer train the immune system to attack the patient’s own cells, rather than an invading virus. Researchers, therefore, have to find ways to direct the immune response to cancer cells to avoid damaging healthy tissue.

To minimize effects on normal, noncancerous cells, therapeutic cancer vaccines train the immune system to recognize proteins that are either absent from normal cells or found at significantly lower levels on normal cells. Vaccines expose immune cells to these proteins in various ways, based on the type of vaccine.

PROTEIN-BASED VACCINES

Sipuleucel-T (Provenge), the sole FDA-approved therapeutic vaccine for cancer, was greenlit in 2010 for prostate cancer. It works by delivering small pieces of a protein found at high levels in prostate cancers. When the patient’s immune cells encounter the delivered protein, they become more likely to attack prostate cancer cells.

Multiple protein-based vaccines delivering other target proteins are under investigation for a variety of cancer types, including head and neck, lung, pancreatic, brain, and colorectal cancers, among others.

While protein-based cancer vaccines can be highly effective and well tolerated, they are expensive, time-consuming, and oftentimes difficult to develop.

RNA-BASED VACCINES

Another category of cancer vaccines uses messenger RNA (mRNA)—the same design used to develop the first COVID-19 vaccines. Instead of delivering the target protein, these vaccines provide cells with the genetic instructions (in the form of mRNA) to make the protein, which, in turn, stimulates the immune system to seek out and attack cancer.

mRNA-based vaccines can be produced much more rapidly than protein-based vaccines, but delivering the mRNA and preventing bothersome side effects can be a challenge.

mRNA-based vaccines are being tested to treat a myriad of cancer types, with recent success against advanced skin and pancreatic cancers. Many of these vaccines are custom-made for each patient—a level of personalization made possible by the mRNA platform, which allows custom vaccines to be produced quickly and without major delays in treatment.

DNA-BASED VACCINES

Like RNA-based vaccines, DNA-based vaccines deliver instructions to make the target protein, but they provide the instructions as DNA rather than mRNA.

DNA-based vaccines have many of the same benefits as RNA-based vaccines, including the inexpensive and rapid production. DNA-based vaccines, however, may cause autoimmune reactions or impact the patient’s own DNA. Further, administering DNA-based vaccines requires unconventional methods, and once administered, DNA still has to make its way into a specific compartment of the cell to function.

Despite these challenges, DNA-based vaccines have shown clinical promise against various solid tumors, such as cervical cancer, breast cancer, glioblastoma, and others.

VIRAL- AND BACTERIAL-BASED IMMUNE STIMULANTS

While not quite cancer vaccines, a related category of cancer therapy exploits the innate ability of viruses and bacteria to stimulate the immune response. The bacterial strain Bacillus Calmette-Guérin (BCG), for example, was originally developed as a preventive vaccine for tuberculosis but is now also used to treat bladder cancer. When BCG is administered into a patient’s bladder, it triggers an immune response within the organ that helps kill cancer cells.

Researchers are also using modified viruses that preferentially infect and kill cancer cells to release immune-stimulating molecules from cancer cells, with one such therapy approved to treat certain melanomas.

NEW DIRECTIONS IN VACCINE RESEARCH

Researchers continue to explore innovative strategies to improve therapeutic cancer vaccines, combining them with other immunotherapy drugs, using new technologies to identify and test novel designs, and developing faster ways to produce vaccines.

To learn about anticipated progress in the field of cancer vaccines, check out our interview with cancer vaccine expert Catherine J. Wu, MD, FAACR.

Read more

What Is a Cancer Vaccine? 

Consumer wearables could make ‘positive contribution to routine care’

Consumer wearables that measure heart rate and physical activity provide similar clinical value to standard hospital tests for atrial fibrillation (AF) and heart failure, new research has found.

The study, published in Nature Medicine, examined whether a commercially-available fitness tracker and smartphone could continuously monitor the response to medications, and provide clinical information similar to in-person hospital assessment.

The wearable devices, consisting of a wrist band and connected smartphone, collected a vast amount of data on the response to two different medications prescribed as part of a clinical trial called RATE-AF, funded by the National Institute for Health and Care Research (NIHR).

Researchers used artificial intelligence (AI) to help analyse over 140 million datapoints for heart rate in 53 individuals over 20 weeks.

They found that digoxin and beta-blockers had a similar effect on heart rate, even after accounting for differences in physical activity.

This was in contrast to previous studies that had only assessed the short-term impact of digoxin.

A neural network that took account of missing information was developed to avoid an over-optimistic view of the wearable data stream.

Using this approach, the team found that the wearables were equivalent to standard tests often used in hospitals and clinical trials that require staff time and resources.

The average age of participants in the study was 76 years, highlighting possible future value regardless of age or experience with technology.

Professor Dipak Kotecha from the Institute of Cardiovascular Sciences at the University of Birmingham and the lead author of the study said: “People across the world are increasingly using wearable devices in their daily lives to help monitor their activity and health status.

“This study shows the potential to use this new technology to assess the response to treatment and make a positive contribution to the routine care of patients.”

“Heart conditions such as atrial fibrillation and heart failure are expected to double in prevalence over the next few decades, leading to a large burden on patients as well as substantial healthcare cost.

“This study is an exciting showcase for how artificial intelligence can support new ways to help treat patients better.”

https://www.htworld.co.uk/news/wearables/consumer-wearables-could-make-positive-contribution-to-routine-care/