Chronic Disease & Cancer Trends

Chronic Diseases & Cancer Trends

Learn about the latest chronic disease and cancer trends and strategies.

• Obesity: According to new reports from the Centers for Disease Control and Prevention, more than one in five US children and teens (21.1%) ages 2–19 now have obesity, the highest level ever recorded, up from 5.2% in the 1971–1974 survey. Meanwhile, adult obesity rates had a slight decline and may be leveling off, likely in response to public health education and the growing access to GLP-1 weight-loss medications.
• Heart Disease: New projections from the American Heart Association estimate that 6 in 10 women will develop heart disease or stroke by 2050, and that nearly one-third of girls ages 2–19 will have obesity, a top driver of cardiovascular disease. A new study found that heart attack deaths rose among younger adults, with women more likely than men to die in the hospital after a first heart attack. A separate study indicates that routine mammograms to screen for breast cancer may also flag the risk of heart disease.
• Diabetes: People living at high altitudes are less likely to have diabetes than those living at sea level, and new research may help explain why. The research team illustrated how at high elevations, red blood cells begin absorbing large amounts of glucose from the bloodstream, delivering oxygen more efficiently and lowering circulating blood sugar.
• Colorectal Cancer Trends: New data published recently by the American Cancer Society shows a major shift in the demographics of colorectal cancer, with nearly half of all newly diagnosed cases occurring in adults younger than 65 years old.
• Cancer Screening: There has been a growing push to develop better cancer screening tools, particularly blood tests that could detect multiple cancers early. One promising blood test, Galleri, has sold nearly 500,000 kits since 2021 and costs $949, with most people paying out of pocket. However, a major recent study found it delivered disappointing results and failed to reduce the number of people diagnosed with late-stage cancer.

Resources & Initiatives

• The Food and Drug Administration has approved a swallowable balloon designed to assist patients in losing weight, specifically for those who were unsuccessful at weight loss through prior programs.
• Through a Louisiana Blue Foundation grant, HeartSense, a nonprofit working to eliminate disparities in cardiovascular health, is launching an artificial intelligence (AI)-enabled heart screening program led by students at historically Black colleges and universities. This initiative will train students to conduct screenings and bring early detection directly into high-risk communities, without requiring a physician’s presence.
• Blue Cross and Blue Shield of New Mexico is working to close gaps in care and improve diabetes and cardiovascular health outcomes through its Quality Innovation Institute, including through improved member outreach, educational programming, and its mobile health van program.
• Researchers at the Medical University of South Carolina are leading a new effort to transform type 1 diabetes treatment by combining stem cell, immunology, and transplantation research to restore insulin-producing beta cells without the need for immunosuppressive drugs.
• A recent Becker’s Healthcare podcast features Thomas Graf, MD, Chief Medical Officer at Florida Blue, discussing how the health plan is improving cancer care for Medicare Advantage members through a high-touch, technology-enabled navigation program that helps close gaps between diagnosis and treatment, and improves outcomes while lowering costs.

Interview on the Impact of a Diagnostic AI Tool for Coronary Artery Disease

In 2018, Medicare established coverage and reimbursement for its first AI-enabled service: computed tomography (CT) fractional flow reserve (FFR-CT). A new Health Affairs publication by Anna Zink, PhD, Hannah Neprash, PhD and Michael Chernew, PhD, explores the adoption of FFR-CT and its impact on the diagnosis of coronary artery disease through cardiac imaging. Learn more in this exclusive interview with Anna Zink.

Q: What impact did the AI diagnostic tool have on utilization, costs, and health outcomes? 
A: Clinicians who adopted the AI diagnostic tool for diagnosing coronary artery disease (CAD) changed the basket of tests they used, moving away from invasive testing and toward AI-assisted testing and its required underlying imaging. Ultimately, this increased spending per newly diagnosed patient because the savings from fewer invasive tests were offset by the cost of the AI diagnostic tool and its associated imaging. We did see some evidence that adoption of this tool was associated with improved health outcomes in the year following use, and we hope to do more research to understand the long-term outcomes of AI adoption. We also saw some early evidence that the AI diagnostic tool might increase physician productivity, in the form of higher visit volume post-adoption.

Q: Why are these findings important for the current policy discussion around AI in health care?
A: The Centers for Medicare & Medicaid Services (CMS) is thinking carefully about how to price these new AI diagnostic tools (as they decide whether to reimburse for their use) and getting that pricing right is challenging! In our paper, we saw the mechanisms working as expected (i.e., a decrease in expensive, invasive testing), but because the price of the AI diagnostic tool was set so high (in addition to the imaging required for the test), no net savings were realized. There may be savings down the line in the form of avoided treatments and adverse health events, but CMS is unlikely to have that evidence available when setting initial pricing.

This analysis is supported by a NIHCM Research Grant.