Cancer is a leading cause of mortality in the United States and across the world. It also is one of the major illnesses that cause individuals to worry. Cancer can be diagnosed through screening, when it is asymptomatic, or when symptoms are present. If an individual is diagnosed via screening, their chance of being cured from cancer is higher and thus screening is encouraged in cancer types that have the option for screening. Currently, routine screening tests are recommended by the US Preventive Services Task Force for breast cancer, cervical cancer, colorectal cancer, and lung cancer. But 71% of cancer deaths in the United States come from cancers without recommended screening tests.1 As a result, many cancer patients don’t receive a diagnosis until their cancer has progressed to a later stage, which may limit their treatment options. The CDC estimates that of cancers diagnosed between 2011-2017, 98% of people diagnosed with cancer at stage I were still alive after 5 years, whereas only 30% of people diagnosed at stage IV were still alive.2
Causes of delayed cancer detection
Dismissal of cancer symptoms in young populations
Younger populations are seeing a rise in several cancer diagnoses, and their symptoms are often dismissed because of the patient’s age. For example, people born in 1990 now have double the risk of colon cancer and quadruple the risk of rectal cancer than people born in 1950,4 but patients and doctors alike might not consider cancer to be the cause of symptoms because it used to be more prevalent in older populations. It wasn’t until recently that the American Cancer Society amended guidelines to lower the recommended age of screening for colon cancer from age 50 to 45.5
The COVID-19 pandemic caused many people to delay in-person screenings and treatment. In addition to the COVID-19 pandemic, those with financial insecurity and other existing challenges, like socio-economic status, health comorbidities, childcare responsibilities, and lack of access to medical care, face higher barriers to accessing routine cancer screening.6
Social determinants of health
Additionally, a troubling gap exists between cancer treatment and outcomes based on race, ethnicity, socioeconomic status, sexual orientation, and other characteristics. The contributing factors to these cancer health disparities are complex, such as genetics, a lack of medical research across diverse study subjects, and differences in access to care. Those living in disadvantaged neighborhoods are more likely to be diagnosed with late-stage cancer and face poorer survival rates, and precision medicine may not consider the genetic differences of racial and ethnic minorities.
Precision medicine for the treatment of cancer
Regardless of mode of diagnosis (screening or otherwise), receiving timely evaluation and treatment is essential in improving outcomes and fighting cancer. That said, treatment for most cancers is not an emergency and patients can wait a few weeks to be seen by the right team for management of their cancer.
Early intervention after a cancer diagnosis is critical to optimize treatment. All patients with cancer deserve the best chance of survival and have better chances with optimized treatment tailored to their specific diagnosis.
National Cancer Institute (NCI)-Designated Comprehensive Cancer Centers use precision medicine to identify genetic or molecular indicators of cancer to detect certain cancers early, accurately determine a diagnosis, develop a personalized treatment plan and prevent care mismatches. As such, people who are treated at NCI-Designated Comprehensive Cancer Centers have a significantly higher chance of survival than those treated at community hospitals.7
Yet only 20% of patients with cancer receive care at an NCI facility.8,9 Predominantly located in metropolitan areas, NCI centers can be geographically prohibitive for patients in rural communities. To bridge the gap in cancer health outcomes, AccessHope was founded to facilitate access to leading cancer expertise across the country regardless of the individual’s ZIP code or individual characteristics.
1 Beer, T. Examining developments in multicancer early detection: highlights of new clinical data from recent conferences. American Journal of Managed Care. 27(19); S347-S355.
2 Centers for Disease Control and Prevention. Incidence and relative survival by stage at diagnosis for common cancers. USCS Data Brief, no. 25. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2021.
3 Miller, K, et al. Cancer treatment and survivorship statistics, 2022. CA: A Cancer Journal for Clinicians. 2022; 72(5).
4 Siegel, R. Colorectal cancer statistics, 2020. American Cancer Society Journals. https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21601. Published March 5c 2020. Accessed September 14, 2022.
5 American Cancer Society. When should you start getting screened for colorectal cancer? https://www.cancer.org/latest-news/american-cancer-society-updates-colorectal-cancer-screening-guideline.html. Published February 4, 2021. Accessed September 9, 2022.
6 Newman L, Winn R, & Carethers J. Similarities in risk for COVID-19 and cancer disparities. Clinical Cancer Research. 2021, 27(1): 23-27.
7 Fox Chase Cancer Center. The benefits of treatment at an NCI-Designated Comprehensive Cancer Center. Fox Change Cancer Center Temple Health Web site. https://www.foxchase.org/blog/2018-05-04-benefits-treatment-nci-designated-comprehensive-cancer-center. Updated August 7, 2020. Accessed September 9, 2022.
8 National Cancer Institute. Data table 3: Reportable patients/participation in therapeutic studies. National Institute of Health Web site. https://cancercenters.cancer.gov/DT/DT3. Accessed September 9, 2022.
9 American Cancer Society. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf. Accessed September 8, 2022