Blog Post April 15, 2019 Obesity and Cancer: Five Approaches for Healthcare Providers to Improve Screening and Population Health Authors Lili Hay Ryan Engesser Matt Sturm The most recent CDC report indicated approximately two out of three US adults were overweight or obese, and in recent years, research has started to connect an increasing number of cancers to obesity. According to the CDC, 13 cancers are now linked to obesity.1Today, these cancers make up almost half of all newly diagnosed cancer cases. From 2005 to 2014, incidence rates for these cancers (excluding colorectal cancer) increased by 7%. Research still needs to be done to understand the link, but researchers currently say obesity is directly responsible for 1 in 20 cancer cases. That number will likely continue to rise given overall trends; according to the same CDC report, obesity prevalence in the US increased by more than 100% for children and adolescents between 1980 and 2014, and 60% for adults. A 2019 report in The Lancet Public Health showed that six cancers linked to obesity have been on the rise in obese young adults in particular: multiple myeloma and colorectal, endometrial, gallbladder, kidney, and pancreatic cancer. The Benefits of Addressing Cancer and Obesity under Two Payment Models As obesity is poised to become a major driver for new cancer cases, oncology providers can help address the issue by strengthening screening programs and population health efforts. While the primary outcome of these efforts will be the delivery of more comprehensive and coordinated patient care experiences, there may be additional impacts under the fee-for-service (FFS) and value-based payment models. Traditional FFS Models: For programs that operate under traditional FFS models, efforts that differentiate their cancer programs within the marketplace may increase patient capture rates. Value-Based Payment Models: Programs participating in value-based payment models may see financial benefits related to effective population health efforts that drive reductions in overall cancer cases. Five Approaches for Improving Screening and Population Health Suggested approaches for improving screening and population health activities include the following: 1. Coordinate cancer and bariatric programs.Given the prevalence of overweight or obese cancer patients, offering consults with bariatric services may prove beneficial. These consults would encourage a discussion about the link between obesity and cancer and about the potential benefits of weight-loss techniques to reduce the risk of recurrence or new cancers. Cancer screening services should also be offered to bariatric patients. 2. Integrate weight management programs into cancer screening, prevention, and survivorship programs. With obesity linked to an increasing number of cancers, integrating weight management and nutrition services into the oncology program’s screening and prevention efforts is a proactive strategy to increase patient engagement and accountability. 3. Increase cancer screening and education efforts for younger populations. More than half of Americans do not understand the link between obesity and cancer. Providing education to the community, particularly younger populations who are increasingly affected by obesity, will encourage patients to act. In addition to education strategies, exploring cancer screening options for younger populations (in line with current clinical guidelines) will increase the chances of early detection and decrease cancer mortality. 4. Partner with wellness organizations to offer add-on services. Potential examples of these services include: nutrition management and food delivery and/or fitness devices and remote monitoring. Such partnerships could make it easier for patients to achieve their health goals while requiring negligible infrastructure or investment by the oncology program. 5. Integrate cancer screening into broader health system screening and wellness programs. Given the prevalence of obesity in the US, programs should integrate cancer screening services with broader health screening/monitoring programs offered to the community. It is important that oncology programs understand the connection between obesity and cancer and begin making plans to respond to the issue. Successful screening and education programs not only have the potential to improve the health of communities served but also to differentiate the oncology program and better position it to serve those who develop cancer. Footnotes 1. The 13 cancers are breast, colorectal, endometrial, gallbladder, kidney, multiple myeloma, pancreatic, liver, upper stomach, ovarian, esophageal, brain and spinal cord, and thyroid.