Four shifts shaping the future of oncology care and treatment

There’s no denying that cancer rates continue to be a concern: Every year, roughly 20 million people worldwide are diagnosed with cancer.¹ Around 2 million² of these annual cases occur in the United States, where, despite an overall reduction in cancer deaths in recent decades, diagnoses have ticked upward in the last year, particularly among younger adults.³ All told, Americans have about a 40% chance of developing cancer at some point in their lives.⁴

While these figures are certainly frightening, cancer researchers continue to unearth new breakthroughs at a rapid clip. Medical advances are accelerating thanks to a powerful confluence of technology, human ingenuity and major financial investment. Specifically, an improved understanding of how cancers grow and spread has begun to transform how the medical community prevents and treats this formidable disease. Today, the power of patients’ own immune systems can be harnessed to target many forms of cancer, introducing fresh options when conventional approaches fail.

This new pathway in the cancer care continuum is nothing short of revolutionary — and cause for continued optimism. But progress also introduces urgent new questions: How does the healthcare industry shoulder the tremendous cost of these new treatments? How do providers, payers, and patients stay up-to-date on rapid-fire cancer technology advancements that may change evidence-based treatment recommendations? And how can our society provide more integrated oncology care to deliver better outcomes while minimizing pain, frustration and financial waste? 

To answer these questions and look ahead to the future of cancer treatment, we examined a few trends that are rapidly transforming oncology care. 

Cancer, like so many other health conditions, has better treatment options and better outcomes when there is early detection. As the number of cancer cases rises, the imperative to catch the disease early also increases. Diagnosing cancer at an early stage has the greatest impact on improving overall survival because it provides time to find successful treatments and lets doctors stop the disease before it can spread. 

Beyond improving outcomes, early cancer detection can dramatically reduce treatment costs.⁵ Treating spreading cancer can be up to 7 times higher in cost than treating early-stage, localized disease.⁶ Other studies have shown that indirect cancer costs — including reduced productivity and increased absenteeism — are significantly greater among patients diagnosed with cancer at late versus early stages.⁷ Collectively, early detection is associated with potential annual cost savings of $26 billion.⁸

Accordingly, payers, providers and employers should take every possible step to improve cancer risk awareness and increase screening rates, as well as to broaden access to preventive care through telehealth and testing kits. In particular, hosting convenient, on-site cancer screening events; offering benefits that include paid time off for cancer screenings; and sending regular educational emails or newsletters can help counteract common barriers to screening compliance.

Payers can also go even further, partnering with providers and leveraging de-identified EHR data to create and deploy powerful prediction models that can potentially identify patients with cancer earlier. These models can combine EHR data with other imaging or biomarker screening tools to target high-risk patient populations and accurately identify early-stage patients.

In one study, researchers used de-identified payer EHR data to build a prediction model for pancreatic cancer based on nearly 30,000 cases of the disease over 8 years. The model included more than 18,000 features, from diagnoses and procedures to clinical notes and medications, that could detect 58% of late-stage pancreatic cancers a median of 24 months before their actual diagnosis.⁹

These types of models can make a real difference in patients' lives. Payers can use them to drive real-world interventions, like proactively sending at-home colon cancer screening kits or assisting in helping individuals access care. Combined with other preventive efforts, predictive models have the potential to dramatically mitigate cancer’s heavy physical, mental and financial burden.

For generations, cancer experts have known that the older one gets, the greater their likelihood of cancer becomes.¹⁰ However, changes in patient demographics are upending some of what we’ve always known about who gets cancer and when — and the provider and payer communities must pay close attention to continue to provide effective care in the years to come. 

A recent spate of “early onset” cancers among adults under the age of 50 — particularly in breast, lung, tracheal, stomach and colorectal cancer diagnoses — has experts concerned.¹¹ This sudden shift has been attributed to everything from rising obesity rates to environmental carcinogens, sedentary lifestyles, and processed food,¹² but whatever the reason or reasons may be, the fact remains that healthcare providers and health plans must rethink the ways in which they recommend and cover preventive testing for certain cancers. Just this year, the U.S. Preventive Service Task Force changed its guidelines for a patient’s first mammogram from between age 40 and age 50 to age 40¹³ — and as many confused patients and providers will tell you, this isn’t the first switch-up in recent memory. 

The takeaway? Staying abreast of changes in the field of oncology, particularly the evolving demographics of the common cancer patient, can help plans and providers meet patients where they are, ensuring that younger patients are appropriately referred for preventive testing and, when indicated, genetic testing.

Today, personalization is a given in everything from social media feeds to sandwiches — and, increasingly, in oncology detection, care and treatment. Technological and scientific progress have helped experts better pinpoint the genomic profiles of cancers that are unique to each patient’s tumor that can be targeted by customized treatments. This personalized approach has been called the “best new weapon to defeat cancer.”¹⁴

Precision oncology’s applications are numerous, starting with the potential to predict or detect cancer in patients who show no symptoms of the disease.¹⁵ This bespoke approach continues if and when cancer is diagnosed. Genomic testing to determine the characteristics of a patient’s cancer can be performed either using tissue from the cancer or by using a sample of the patient’s blood. Knowing the genomic subtype of a patient’s cancer can be highly useful in determining a targeted course of treatment and helping medical professionals make more informed, customized and effective decisions. 

Currently, the types of cancers for which treatment decisions are based on certain genomic findings include colorectal, breast, lung, melanoma, esophageal, stomach, ovarian and thyroid cancer, lymphomas and leukemias.¹⁶ The potential for precision oncology to result in lifesaving intervention is huge, considering that three of these cancer types — breast, lung and colorectal — are high on the list of the most prevalent forms of cancer in the United States.¹⁷

Accordingly, research into the field is exploding: Between 2019 and 2023, a full 30 percent of clinical cancer trials around the globe were focused on precision oncology.¹⁸ As emerging treatments proliferate, payers and providers will be incentivized to partner in order to standardize genomic evidence gathering requirements and speed the adoption of precision medicine. By providing more clarity around the clinical validity and utility of new genomic tests and precision medicine interventions, payers and providers can ensure patients receive the highest-quality, most effective care. 

Oncology care requires a high-touch, personalized experience to ensure that patients receive top-quality care while avoiding unnecessary hospitalizations and inappropriate treatment. Increasingly, payers and providers recognize the value of a specialized support network that provides patients with an entire team of cancer experts and nurse managers who can help them navigate their insurance networks, learn about their diagnosis, understand their treatment regimens, manage their pain and other symptoms, and discuss palliative and end-of-life care.

At the same time, cancer treatment innovations within the digital and virtual realm mean that patients can access online libraries of articles, videos, and easy-to-use tools curated by cancer experts. Additionally, wearable devices and other digital tools can help providers monitor patients’ side effects and symptoms while improving overall care. According to a recent survey of patients, caregivers and providers by the Association of Community Cancer Centers, these digital devices were effective in tracking symptoms between appointments, receiving alerts if medical intervention is necessary, improving patient outcomes, and reducing the risk of hospitalization and emergency department visits.¹⁹

By using all available tools and modes of care, payers and providers can unite to improve communication and rapport between patients and their care teams and deliver better outcomes at reduced costs — while minimizing burdensome disruptions in the patient’s life. 

As the oncology landscape shifts, those within it will be forced to adapt, too. New methods of detection and prevention, different approaches to diagnosis, more options with future cancer treatments, and the changing face of today’s cancer patient demand that those within the field rise to a new understanding of cancer care — and a new appreciation for collaboration’s vital role in improving outcomes while managing costs.

The field of oncology is changing rapidly, but having a partner in your efforts to adapt can make all the difference. Optum offers holistic managed care programs that guide and support members from cancer prevention to post-treatment. Learn more about how Optum can help.