Cancer: how to stop the next global health crisis

The full impact of the global pandemic is not yet known, but the sudden effects of COVID-19 have already disrupted cancer care.

Stay-at-home orders and fear of contracting the virus led many people to suspend screenings, defer routine visits, and avoid or delay seeking care. And without visiting their doctors, people with cancer have not been able to benefit from the incredible progress made in oncology in the last few decades, setting back survival rates and early diagnosis.

But there is hope.

Times of adversity bring opportunity for innovation and collaboration, especially now. As cancer screening, diagnostics and treatment continue to advance, the global cancer community will have an arsenal of new tools to not only reverse these declines but accelerate progress.

Before the pandemic, cancer death rates were trending downward at an encouraging rate. From 1991 to 2017, the US saw cancer deaths decrease by 29%. In the EU between 2014 and 2019, cancer mortality continued to fall for both men and women. Increased and earlier screening coupled with enhanced diagnostic technology and breakthrough advances in personalised, tailored treatment led to more patients understanding their cancer diagnoses sooner and accessing necessary care faster.

But despite these many advances, the global instability people faced from COVID-19 resulted in a dramatic disruption to vital cancer screenings and treatment.

A recent survey from the American Cancer Society Cancer Action Network reported that more than three-quarters of people actively undergoing treatment for cancer had to delay some aspect of their care as a result of COVID-19. In addition, the US National Cancer Institute warned drops in screening for breast and colorectal cancer alone may lead to up to 10,000 additional deaths in the next decade.

We know that early diagnosis improves survival rates. When cancer is caught in the early stages, patients have more treatment options and less complex care, which not only benefits patients but allows for less costly care, saving money and resources for the whole health system. Now, more than ever, the global cancer community needs to come together, reprioritise screenings and minimise setbacks to healthcare systems and society. If you consider lung cancer as an example, the disease claims 1.8 million lives every year worldwide. It also carries the heftiest economic burden of all cancers – almost €19 billion is spent each year on lung cancer in Europe alone. Yet currently, only around one in five patients with lung cancer are diagnosed at Stage I.

The “Lung Cancer Screening: The Cost of Inaction" report developed for the Lung Ambition Alliance found that targeted screening using low-dose CT (LDCT) scans can significantly reduce the cost burden and improve the chances of survival by increasing the discovery of early-stage lung cancers. Indeed, one study found that in patients with certain risk factors, for every 320 LDCT scans, one life could be saved. To put that in context, the number is much higher for other cancer screenings – over 800 for colorectal cancer, and ranging from 600-1,700 for breast cancer.

We have the tools to carry this out, and have outlined a strategy for the successful implementation of lung cancer screening at scale to help mitigate disruptions to cancer care in the event of future health crises like COVID-19 in a case study developed for the Partnership for Health System Sustainability and Resilience. Screening can also reduce the economic burden placed on healthcare systems – one estimate from the US suggests a $26 billion cost savings from early cancer diagnosis. This approach supports long-term sustainability of both healthcare systems and governments in achieving their goals of reducing cancer mortality.

The speed and agility of the cancer community’s response to COVID-19 gives hope for rapid progress moving forward. Together, we established new partnerships and collaborations, accelerating our collective progress in safeguarding the healthcare system to reduce premature cancer mortality.

By bringing together expertise across fields, we’ve leveraged advances in technology to support patients from diagnosis through to treatment. Artificial intelligence (AI) is one tool already demonstrating promising capabilities toward this goal. AI has been shown to successfully detect up to 93 per cent of abnormal lung growths in recent studies, which can mean significantly increasing capacity for identifying patients, streamlining care pathways and maximising resources for the healthcare system. At the same time, we are reinventing how people can access and deliver care through digital and home-care solutions that increase capacity and reduce the burden and cost on healthcare facilities.

Now is the time for healthcare providers, academic institutions, industry and global health organisations to partner in harnessing the latest scientific progress in oncology in service of patients. Early detection is critical to ensuring the future sustainability and resilience of health care systems.

Together we must commit to:

We are at a crossroads of cancer care; one route optimises care and changes what it means to receive a cancer diagnosis, the other exacerbates the setbacks we are currently experiencing. Early detection and prediction are critical to mitigating both infectious diseases and cancer. We must improve the earlier detection of cancer to improve patients’ chances of prolonged survival.

Taking this path forward, we can stop one health crisis from fuelling another.