Cancer Won't Wait for COVID

The data are clear: Critical preventative care has suffered at the hands of COVID-19. From a 90% decline in colonoscopies to a 79% decline in Pap tests, the pandemic has created a dangerous new normal where delayed care, skipped well visits, and postponed procedures have become commonplace. Web Sun, co-founder and president of Komodo Health, shares new data on cancer screening, diagnosis, and treatment in the age of COVID and why these insights from real-world patient experiences are key to creating a more patient-centric approach to population health long after the virus is behind us.

COVID-19 has created a historic level of disruption in our everyday lives, causing us to cancel or postpone everything from weddings to vacations to new business ventures. While that’s been frustrating for all of us, most of these things can wait. But some of the things that have been put on hold these last several months are creating far more serious side effects. As a case in point: the total number of colonoscopies performed this year was down roughly 90% through April.

That’s a massive problem. Colorectal cancer is the third most common cancer in men and women and the rate of new colorectal cancer cases among younger people has been rising. When colorectal cancer is detected early, up to 90% of patients survive for five years or more. However, when detected in more advanced stages, the five-year survival rate falls to around 14%.

This grim statistic was thrust into the spotlight last month with the death of 43-year-old actor Chadwick Boseman. Boseman was diagnosed with stage 3 colon cancer in 2016. As an otherwise healthy young man who starred in blockbusters like Black Panther and graced the covers of countless celebrity and fitness magazines even after he was diagnosed, Boseman in particular didn’t look like someone who could die from colon cancer. Only a colonoscopy would have been able to see past the superhero image to reveal the lurking issue before it was too late.

The problem is – many people avoid getting a colonoscopy, even before COVID-19 introduced yet another barrier. This has been a particular issue in the Black American male population, where preventive screening rates are significantly lower than in the white population. Black men are more likely to be diagnosed in the disease’s most advanced stages – yielding a 5-year survival rate of just 9%.

Tracking the Ripple Effects of COVID-19 on Preventive Care

That’s what makes the findings of our analysis of colorectal cancer screening and treatment during the pandemic so startling. Beyond the 90% decline in colonoscopies, we also saw a 32% decline in new colorectal cancer diagnoses and a 53% decline in colorectal cancer surgeries compared to last year; even patients who knew they had colon cancer were putting their potentially life-saving interventions on hold.

To look more closely at some of the behaviors that were driving these trends, we teamed with the advocacy group Fight Colorectal Cancer (Fight CRC) to survey and conduct focus groups with colorectal cancer patients. We found that 40% of patients and their caregivers experienced some form of disruption in their care during the pandemic. Not surprisingly, we also found that the vast majority of patients (78%) said they felt nervous, anxious or on-edge about coronavirus exposure risks associated with their treatment.

Unfortunately, it doesn’t stop there. Throughout the pandemic, we’ve been tapping into our database of real-world patient encounters with the healthcare system to track the ripple effects of COVID-19 on other aspects of healthcare. Across all disease and patient populations, we’ve seen massive declines in preventive care, including a nearly 79% decline in cervical cytology screening (Pap test), a 22% decline in biomarker testing for multiple myeloma and a 17% decline in monitoring for breast cancer recurrence. We’ve even found meaningful declines in the number of required pediatric immunizations that have been administered this year versus last.

Interventions Needed to Address COVID-Driven Gaps in Care

All of these data points paint the same, grim picture: critical preventive care has suffered at the hands of COVID-19. The pandemic has created a dangerous new normal where delayed care, skipped well visits and postponed procedures have become commonplace.

But cancer won’t wait for COVID-19 to run its course. The fact that diagnoses are down is an unsettling indication that more and more people are living with undiagnosed cancer. That’s a problem we cannot afford to leave unaddressed.

We need to start tracking these COVID-driven gaps in care to identify the populations who are most at risk and start developing interventions and patient outreach programs to get back on-track. Most importantly, we need to be able to identify high-risk hot spots at a granular level, pinpointing the specific segments of the population and even specific conditions that are being left behind while the world is focused on the immediate, direct threat of COVID-19.

That’s going to require a laser focus on real-world, real-time patient data that helps us understand the complete patient journey. Even before COVID-19, identifying and addressing the discrete variables that led to gaps in care was a major challenge, one that was fraught with data accessibility issues, lack of coordination between providers and institutional inertia. Today, that challenge continues as a combination of technology issues, political infighting and disagreement over the most important data points to track has stymied public health efforts to collect accurate data on COVID-19 infection rates. We need to break down those artificial barriers and focus on the concrete facts of individual patient experiences if we’re going to accurately identify and address the gaps in care that exist throughout the U.S.

With a more thoughtful approach rooted in data and data science, this crisis could be an opportunity to better use insights from real-world patient experiences to improve health outcomes nationally. While the pandemic has forced a closer look at populations that are not receiving the right standard of care, the idea of a more patient-centric approach to population health is one that will improve healthcare long after COVID-19 is behind us.

We have the data. It’s time to start using it to ensure that we all get the care we deserve.

About the Author:

Web Sun is Co-Founder and President at Komodo Health, where he oversees operations including business development, sales and marketing, and people.

Prior to founding Komodo Health, Web was a Managing Director at Zephyr Health, a leading life sciences data and insights solution provider, running all non-Engineering functions. He spent nearly eight years as vice president at Campbell Alliance (now Syneos Health) where he advised enterprise life sciences companies across corporate development, brand management and marketing, commercial effectiveness and medical affairs initiatives.

Web also serves as an Executive Advisor to Reify Health, Heads Up Health and other healthcare/healthtech startups focused on Big Data, SaaS, Healthcare IT, and Predictive Analytics to improve patient outcomes.

Web holds an MBA in Marketing & Finance and International Business from the New York University Leonard N. Stern School of Business and a triple major in Molecular Biology/Biochemistry (MBB), Biological Sciences and Psychology from Rutgers University.

Want to Learn More?

Watch Web Sun and Dr. John Torres of NBC News discuss the critical role of data science in better understanding patient behaviors and accurately identifying gaps in health care.