Note: This commentary is based on the panel discussion ‘Demographic shifts and building resilient health systems’ at the 2022 Chatham House London Conference. Content includes points shared by co-panelists. The session recording is available here. 

Geopolitical conflicts, climate crises and the COVID-19 pandemic have sent shockwaves around  the globe but a much subtler worldwide shift may ultimately impact all our societies in an even more powerful way: ageing. According to the UN, 1 in 6 people worldwide will be age 60 or older by the year 2030 and while increased life expectancy is an indicator of success for our health systems, people who live longer face a new challenge in the inevitable rise of noncommunicable diseases—especially cancer.

Cancer is already one of the world’s leading causes of death, and the number of new cases is expected to increase globally from 19 million in 2020 to 26 million in 2030. Helping these patients live longer, healthier lives is within reach as more treatments become available: over a quarter of the 410 new medicines approved by the FDA between 2011 and 2020 were anti-cancer therapies, while the number of EMA-approved cancer medicines has increased from around four per year between 2001 and 2011 to about 10 per year between 2012 and 2018. As science and technology evolve, the ways we detect, monitor and manage disease within our health systems must evolve as well and at the same pace.

Prioritise ‘Early’ Cancer Care

For years, most cancer care systems have focused on extending the lives of cancer patients, many of whom were subject to a late diagnosis. With unprecedented advances in early detection and early treatment of cancer now underway—such as liquid biopsies, which can potentially detect multiple cancers early on through bloodwork and early-stage cancer therapies with the intent to cure —it is time to prioritise ‘early’ cancer care. By this, I mean trying to ensure people with symptoms of cancer are diagnosed, treated and cared for as early as possible.

The potential benefits from such a strategy change can’t be underestimated. If diagnosed at the earliest stages of the disease, for example, breast cancer patients have a 98% chance of surviving for five years or more, compared to 26% when diagnosed at the latest stage.

A paradigm shift toward early cancer care should not only improve patient outcomes but also allow us to imagine a future where cancer patients achieve and maintain a life that is not dominated by their cancer and possibly reach a similar life expectancy as those who’ve lived cancer-free.

Empower Citizens Through Health Literacy and Coaching

Predicting who is likely to develop certain cancers, and then detecting those cancers early on, is becoming more of a reality every day. The next step: empowering patients to understand and respond to that information. In cancer care, where new technologies, modalities, and medical terms are burgeoning, there is an urgent opportunity to improve health literacy and health coaching services. Helping all patients access healthcare systems and manage diagnoses, treatment options and lifestyle modifications in a way that works for them will be key to leveraging new technological advances and will all help drive better outcomes.

Invest in Technology and People for Better Cancer Care

Healthcare funding should continue to be seen as an investment in people and communities. Spending on cancer as a share of total health expenditure has been around 4–7 percent in Europe over the past 20 years, but the composition of the spending has changed: Expenditures on inpatient care have declined, while those on ambulatory care and cancer medicines have increased.

This change is largely driven by today’s cancer therapies that have enabled shorter hospital stays, better side-effect management, quicker recovery, and potentially fewer recurrences. In addition, innovative medicines made many previously untreatable patients eligible for therapies. Countries like the UK and Italy have established cancer drug funds to harness innovations promptly. Governments can maintain a stable level of healthcare expenditure on cancer while improving cancer survival by prioritising innovative therapeutics.

Political Commitment to Cancer Care
Policy frameworks and political will are needed to leverage innovative cancer care, prioritise early cancer diagnosis and treatment, empower citizens to make smart health decisions, and support continued funding of cancer services. It is exciting to see emerging policies—such as Europe’s Beating Cancer Plan, the 10-year Cancer Plan in the UK, National Decade Against Cancer in Germany and the Moonshot Initiative on Cancer in the US—tackling these systemic challenges. Major stakeholders in cancer care must work collaboratively to foster knowledge-sharing and priority alignment on early diagnosis and treatment to enable many more patients to live longer and healthier lives. Cancer doesn’t rest, and neither will we.

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References:

1. An overview of cancer drugs approved through expedited approval programs and orphan medicine designation globally between 2011 and 2020
2. Comparator Report on Cancer in Europe, 2019. (2020)
3. Cancer Research UK Breast Cancer Statistics. (2022).
4. The global burden of cancer: priorities for prevention