The Progress of Prevention—The Culmination of 20 Years of Advocacy

May 14, 2015

This post originally appeared on the National Coalition for Cancer Survivorship blog.

Twenty years ago NCCS defined quality cancer care to include a full spectrum of necessary services for cancer patients. These included primary and secondary prevention, early detection, initial treatment, supportive therapies to manage pain, nausea, fatigue, and infections, long-term follow-up, psychosocial services, palliative care, hospice care, and bereavement counseling.  This principle, and all of the imperatives for quality cancer care, are as valuable and timely today as they were when they were first released.

Over the past two decades we have seen tremendous progress in cancer care, particularly in prevention and early detection. More than half of cancer deaths in the United States are a result of preventable causes.[1] Prevention is by far the most logical solution to better health outcomes and reduced health care spending as these strategies can save 4.5 million lives and up to $600 billion dollars in healthcare spending over the next 25 years.[2]

The culmination of years of advocacy for preventive care was the requirement in the Affordable Care Act (ACA) of over a dozen preventive health benefits in insurance plans. These include annual wellness visits, cervical and colorectal cancer screening, diet, obesity, and tobacco use screening, and immunization vaccines which are all important public health measures to help prevent cancer or detect it early when it is most treatable.

These benefits are provided without cost-sharing obligations (such as copayments, co-insurance, or deductibles) for the patient. Free or low-cost access to these services is critical to health and wellbeing of individuals and families in our nation, particularly vulnerable and underserved populations who would otherwise be unable to afford such care. This approach is particularly important when you consider the impact of health disparities and the opportunity to intervene at an early stage and significantly influence health outcomes.

The ACA also established the Prevention and Public Health Fund which provides expanded and sustained national investments to improve health outcomes and to enhance health care quality. It is the first mandatory funding stream to improve public health while finding solutions to escalating health care costs.

While the preventive measures included in the ACA are important steps in the right direction, we still have considerable work to ensure a healthy future for all. Currently, Americans utilize preventive services at about half the recommended rate.[3]  Additionally, two-thirds of Americans are obese or overweight[4] and nearly 20 percent use tobacco products.[5] Seven in ten deaths in the U.S. are related to chronic diseases[6] including cancer and 75 percent of $2.5 trillion annual healthcare dollars are spent on the treatment of chronic diseases[7].

Organizations like NCCS and the Prevent Cancer Foundation set the stage over the past several decades to save lives through prevention and early detection. The time has come to ensure that we build upon this progress and ensure that people know about and can access preventive services and take action to implement cancer risk reduction techniques in their daily lives.

[1] American Assoociation for Cancer Research. AACR Cancer Progress Report 2014. Clin Cancer Res 2014;20(Supplement 1):SI-S124. 

[2] Milstein, Bobby et al. “Why Behavioral And Environmental Interventions Are Needed To Improve Health At Lower Cost.” Health Affairs, May 2011

[3] http://www.hhs.gov/healthcare/facts/factsheets/2011/08/womensprevention08012011a.html

[4] http://www.cdc.gov/nchs/fastats/obesity-overweight.htm

[5] http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/

[6] http://www.cdc.gov/chronicdisease/overview/

[7] http://www.hhs.gov/asl/testify/2011/10/t20111012b.html

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