February is Cancer Prevention Awareness Month, and to many employers, that likely sounds like yet another opportunity to highlight standard prevention advice: quit smoking if you smoke, prioritize fresh foods and exercise, and make sure to follow cancer screening guidelines. But the truth is that there is much more to this issue than this one-size-fits-all advice. Increasingly, health experts and employers alike are discovering that no standardized message is enough to adequately solve this persistent problem.

FAST FACTS:
- A little over 2 million Americans are diagnosed with cancer each year, and more than 600,000 die from the disease, according to the American Cancer Society.^[1]
- Research suggests that less than half of cancers can be prevented by a healthy diet and lifestyle alone.^[2]
- Only 14% of diagnosed cancers in the U.S. are detected by a recommended screening, per research from the University of Chicago.^[3],[4]

Cancer: A Crucial Battleground in the Fight Against Health Inequity

Trends in cancer diagnoses and deaths have for years reflected troubling racial, ethnic, and socioeconomic disparities that are largely driven by social factors—not just personal lifestyle choices. In one of the starkest examples of this problem, Black Americans are more likely to die from many types of cancer than any other racial or ethnic group.^[5] The causes of this inequality are complex, but in many cases relate to unequal access to resources, such as socioeconomic status, access to care, health insurance, stable employment, housing, and healthy food.^[6]

These factors, often referred to as social determinants of health (SDOH), are responsible for a whopping 80% to 90% of health outcomes—while quality of medical care accounts for only 10% to 20%.^[7] Translation: Reminding employees not to smoke and to fill their plates with whole foods is good, but it’s a mere drop in the bucket when it comes to actually addressing the causes of cancer in America.

That’s not only true for Black Americans. SDOH also play a major role in other groups’ cancer burden: Rural Americans, for example, face a higher risk of certain cancers and are less likely to receive recommended preventive care and cancer screenings than their urban counterparts.^[8]  Meanwhile, Hispanic Americans are roughly twice as likely to die from liver and stomach cancer than white Americans.^[9] Native Americans, Asian Americans/Pacific Islanders and LGBTQ Americans also carry a disproportionately outsized risk for certain kinds of cancer.^{[10],[11],[12]}

By the Numbers: A Glance at How Different Cancers Affect Different Populations

• 2x: The likelihood that Black/African American men will die of prostate cancer, as compared to white men^[13]
• 58%: The rate at which breast cancer is diagnosed while still in an early—and thus more treatable—stage in Black women, as compared to 69% among white women^[14]
• 2x: The likelihood that Asian/Pacific Islander adults will die from stomach cancer as compared to white adults^[15]
• 35%: The increase in deaths from colorectal cancer for men in the poorest counties of the U.S., as compared to men living in the country’s most affluent counties^[16]
• 70%: The increase in likelihood of being diagnosed with cancer that bisexual women face, as compared to heterosexual women^[17]

Cancer’s Impact on the Workplace

Because more than half of Americans receive their health insurance through their jobs,^[18] employers have a critical role to play in addressing these inequities and the many others like them. By making cancer prevention and detection a priority in benefit plans and including strategies to serve vulnerable populations, companies can take the lead in addressing this major human and civil rights issue.

At the same time, there’s also a strong business case for taking a more aggressive stand against health inequity and cancer: Health disparities are responsible for $320 billion in excess health care costs annually.^[19] Cancer costs have now overtaken musculoskeletal conditions as the top driver of employers’ health care outlays,^[20] costing $125 billion in treatment every year and another $139 billion due to workplace absenteeism and diminished productivity.^[21]

Of course, there are countless factors at play that make these grim statistics a reality for millions of Americans. But there are concrete steps that employers can take to help mitigate them. For example, by extending additional benefits beyond the most basic levels of health coverage, employers can address:

• Modifiable risk factors: Offerings such as smoking cessation assistance, exercise groups, and programs that help employees manage obesity and alcohol consumption can reduce cancer and other disease risk.
• Mental health: Mental health benefits can help employees better manage stress and improve sleep and diet habits. Research shows that stress can have a significant effect on a person’s cancer risk.^[22]
• Early detection: Advances in technology have enabled a new, noninvasive way to add screening for many deadly cancers that have no recommended screening tests available. Adding a multi-cancer early detection test can be as easy as a simple blood test that detects a signal shared by dozens of kinds of cancer before symptoms arise.

An Employer Action Plan

Employers can take action to begin dismantling health disparities and fighting cancer while improving both their bottom lines and the communities in which they operate. Here’s a step-by-step playbook for making a difference among your employees.

Step 1: Make Cancer Screenings More Accessible

• Launch a dedicated communication campaign to clarify that cancer screenings are covered by your workplace health plans and will result in no out-of-pocket costs.
• Provide paid time off specifically for cancer screenings to offset lost wages.
• Partner with local healthcare providers or benefit vendors to conduct on-site screenings at your workplace and eliminate the inconvenience of scheduling and attending a screening appointment.
• Survey employees from vulnerable groups about what would help them follow through on getting cancer screenings and take action where possible.

Step 2: Optimize Health Plan Offerings

Thanks to breakthroughs in genetic technology, artificial intelligence, and machine learning, employers now help employees go further with their cancer screenings.

Multi-cancer early detection (MCED) tests can find tiny fragments of abnormal DNA that cancerous cells shed into the bloodstream. Whenpaired with routine screenings, MCED tests can screen for deadly cancers, before symptoms have appeared. Research shows that when cancer is detected early, patients have a wider range of therapeutic options; treatment may be less complex and costly; and outcomes are likely to be more favorable.^[23] That trio of benefits can move the needle toward greater health equity–and reduce cancer’s burden on both employers and employees.

Employers who offer MCED in conjunction with traditional health screenings gain additional benefits, including:

• Easy administration: When MCED technology is offered as a wellness benefit, plans can opt to use claims reserves to pay for testing, and if available, health plan administrators can tap into pre-negotiated pricing. The simple blood draw required for some MCED tests can be scheduled at any of thousands of laboratories across the USA, on-site at workplaces, or in an employee’s home.
• Better employee experiences: MCED technology vendors offer comprehensive support for employees who receive Cancer Signal Detected results, including connections to other relevant benefits you might offer, such as centers of excellence, second opinions, and care navigation solutions.This can provide an unprecedented opportunity for increased engagement with cost-saving, outcome-improving solutions of which employees might otherwise be unaware.

Helping to Close the Cancer Gap

Employers are in fact uniquely positioned to respond to the cancer disparity crisis, and the time is now to do just that. By embracing medical breakthroughs to help underserved and vulnerable employee groups better prevent and detect cancer, companies can ease the undue health burdens that these populations shoulder—while helping all employees live healthy, full lives.

Ailene Bui, Senior Director, Employer and Labor Partnerships, GRAIL, LLC, makers of the Galleri multi-cancer early detection test
www.galleri.com/employers