The cancer data divide: Why integration is the next frontier

A single cancer case generates an enormous amount of data, such as radiology, specialty pharmacy, hospital utilization, care management and behavioral health information.

Taken together, this data should paint a picture of a patient’s experience, from how well their treatment is working to the state of their mental health. Unfortunately, that's not always the case.

A JAMA study found that as much as 71% of non–small cell lung cancer records and 54.7% of breast cancer records were missing key data such as cancer stage, treatment types and demographic information.¹

When oncology data is fragmented, the consequences are very real:

Delayed intervention

In a siloed system, warning signs, like a missed diagnostic follow-up, stay hidden for longer. One study found that every four-week delay in treatment raises mortality by 6% to 13% for common cancers.²

Preventable acute care

Chemotherapy patients visit the emergency department (ED) on average twice per year. The surprising part is that more than half of those visits are potentially preventable with timely outpatient coordination.³

Hidden financial risks

Cancer is now the top cost driver for employers for the fourth year in a row.⁴ And while some high-cost claims are tough to predict, warning signs, like an unfilled prescription or an ED visit, can be found in connected data.

Programs that connect these warning signs can provide quantifiable results, such as the Optum Cancer Support Program (CSP), which delivers a >2:1 ROI. The CSP program uses data to predict risk for complications and hospital utilization. In addition, CSP nurses proactively follow up with members within three business days of a hospital discharge.⁵

To close this divide, payers and employers need help integrating data and insights into workflows. Having a complete view of a cancer patient’s journey, including medical claims, electronic health records (EHRs), pharmacy data and behavioral health insights, is the type of integrated approach that helps uncover high-risk patterns and ensure the right support is delivered to the right patients at the right time.

The proof is in the research. A study of metastatic breast cancer patients found that linking insurance claims to EHRs resulted in better diagnosis coverage and higher adverse event detection rates.⁶

Understanding who is at risk and when is becoming increasingly critical as the cancer risk landscape evolves.

This sea change is underscored by the American Cancer Society’s Cancer Statistics, 2025. Cancer rates in women under 50 are now 82% higher than in men of the same age, up from 51% in 2002.⁷ And while cancer mortality rates among people under 50 have dropped, rates of early-onset cancers are rising by 1% to 2% a year.⁸  That means certain cancers are increasingly affecting working-age adults.

At the same time, the U.S. population is aging fast: By 2035, adults over 65 are projected to outnumber children under 18 for the first time in history.⁹

These shifts point to a risk landscape that is expanding at both ends of the age spectrum, reinforcing the need for timelier and better-coordinated cancer care management to keep up with evolving trends.

For payers and employers, the problem isn't that data doesn't exist. It’s that the data doesn't communicate. The costs of that silence show up eventually, often in the form of avoidable emergency department visits or high-cost acute events.

Here’s how integrated data, when paired with interventions such as treatment coordination and adherence monitoring, can deliver quality cancer care:

1. Acting before problems escalate  

A missed refill or appointment may be more than an oversight. It might signal barriers to treatment such as a lack of transportation or the cost of medication. Medication nonadherence alone is linked to higher hospitalization rates, functional limitations and greater productivity loss among cancer patients.¹⁰

Oncology care management solutions, such as the Optum Cancer Support Program, that draw on authorization data, claims and real-time symptom reporting can help identify high-risk members early and route them to the right support.

The Optum Cancer Guidance Program is a utilization management service for oncology treatments. It leverages technology and appropriate clinical intervention from oncology clinicians to ensure members receive high-quality medical care at lower costs.

Imagine having real-time insight into a member’s medication adherence, recent hospitalizations and symptom trends. Instead of members missing an appointment or leaving a prescription unfilled, they might instead be encouraged to stay on track via timely outreach from a care coordinator.

One study found that predictive models drawing on EHR, behavioral and claims data, paired with proactive nurse outreach, reduced monthly ED visits by 18% for cancer patients.¹¹

For payers and employers, a condition as complex as cancer requires coordination and integration to ensure members' needs are met. The Optum Cancer Support Program is one such offering that pairs members with a designated nurse manager and a team of oncology specialists who support them:

• At diagnosis
• During treatment
• Through end-of-life care if needed

This high-touch approach helps prevent avoidable hospitalizations, ED visits and inappropriate treatment that can add cost and confusion.

2. Treating the whole person, not just the disease

A cancer diagnosis doesn’t just impact a patient’s physical health; it can disrupt their relationships, mental health and finances.

Cancer and behavioral health are especially deeply intertwined. A 2025 review analyzing more than 1.2 million cancer survivors found that 33% experienced depression and 30.5% anxiety. But only half of those who received a diagnosis got treatment.¹²

When behavioral health claims sit in a separate silo, signals can go unseen. That’s a missed opportunity — cancer patients who receive both psychological support and standard therapy have significantly better mental health and quality of life.¹³

Financial stress is also a major concern. High out-of-pocket costs can derail treatment plans. In a study of insured adults receiving cancer therapy, 22% of those experiencing medication nonadherence said they didn't fill a prescription because of cost.¹⁴

Financial data, whether a financial screening test or a record of benefit use, can help identify at-risk patients sooner.¹⁵ This opens doors to interventions like financial navigation, leave planning and employee assistance program (EAP) referrals that can positively change patient trajectories.

3. Matching complex cases to the right expertise 

For rare and complex cancers — roughly one-third of all new cancer cases — where cancer is treated can be just as important as how it is treated. That's because these cancers often involve less standardized treatments and require high levels of expertise.¹⁶

A large-scale review found patients treated at high-volume, specialized cancer centers had 23% lower mortality rates.¹⁷ Connecting members to a national network of carefully evaluated cancer centers can help make this level of care more accessible.

Yet identifying and guiding members toward these providers isn't simple. Many organizations struggle to evaluate outcomes and cost of care across oncology networks.¹⁸

Programs that provide clinical expertise and provider evaluation can help close this gap. Cancer Resource Services, for example, directs members to high-quality cancer centers for rare and complex cancers.

The financial case on its own is compelling. Within Optum, the Cancer Centers of Excellence Network includes 38 leading cancer centers for payers and 40 for employers with UnitedHealthcare, delivering up to 42% savings across inpatient, outpatient and physician services.¹⁹

Integrated data is the backbone for successful value-based oncology programs. Without a complete picture of members' health, payers and employers may struggle to accurately measure outcomes, attribute costs or evaluate partner performance.

As cancer care shifts toward models that focus on outcomes over volume, payers and employers need more than numbers. They need systems and expertise that can better capture information and turn insights into actionable care.

Cancer is already one of the hardest things a person will ever go through. Optum integrated oncology solutions help payers and employers:

• Identify who needs support
• Coordinate care across every touchpoint
• Reduce the costs that come from gaps in the system