There has been a steady decline in cancer deaths over the past couple of decades, driven by a significant decrease in the death rate for lung cancer, which accounts for more deaths than breast, colorectal and prostate cancer combined. This is likely due to progress in three areas: prevention, screening and treatment. Additionally, smoking, which causes 85% of lung cancer diagnoses, has declined over the past 30 years.
While this is positive news, there are warning signs for plan sponsors that there could be a reversal of progress, requiring us to be vigilant and proactive early to prevent such an outcome.
Smoking and lung cancer trends
COVID-19 impacted everything, including smoking trends and the downstream impact on lung cancer diagnoses.
- For the first time in 20 years, there was an increase in cigarette sales. This upward trend could be attributed to pandemic-related stress or less societal pressure to not smoke, since Americans isolated themselves for months to avoid spreading the virus.
- The need to isolate caused significant declines in preventative primary care like screenings and wellness visits. This results in a decrease in a patient’s accountability and a provider’s ability to warn them to the dangers of smoking or to prescribe cessation medications. A recent Evernorth analysis showed a 38% decrease from January 1, 2019, to December 31, 2021, in the use of pills, patches, gum, lozenges, and nasal sprays.
An increase in the use of cigarettes indicates the need for plan sponsors to take action to prevent a worsening of these trends, which could have an impact on member health and plan affordability.
How early interventions get ahead of an increase in lung cancer diagnoses
Plan sponsors need to continue to raise awareness of smoking cessation measures. Ways to do that include:
- Providing access to smoking cessation programs that use a combination of counseling and medications to improve the member’s chances of quitting. For example, digital interventions that use a smart phone like Quit genius have been shown to be effective in improving the chances of quitting.
- Offering incentives to members to begin a smoking cessation program.
- Taking into account the demographic makeup of their member population since data shows that African Americans, Latinos, and American Indians who historically were targeted by tobacco marketing are less likely to undergo screenings and more likely to be diagnosed with an advanced stage cancer.
Percentage of adults Who Reported Tobacco Product Use (%)
If plan sponsors take action now on curbing the use of tobacco products, their members and their plans can benefit from lower costs and better health outcomes. Delaying action runs the risk of missing out on the positive trends that we’d seen prior to the pandemic. There is still time as long as we address these trends early.