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Research & Evidence

Employers and insurers can use employee benefits effectively to fight cancer.
Cancer Screening: Payer Cost/Benefit thru Employee Benefits Programs
Bruce Pyenson, FSA, MAAA, and Patricia A. Zenner, RN
Milliman: Consultants and Actuaries

2017

Commissioned by Bristol-Myers Squibb. "Cancer in the Workplace." The Economist Intelligence Unit , February 17, 2017.

The impact of cancer looks set to continue to grow for organisations in the decades ahead. Experts predict continued growth in the numbers of the working population affected by cancer as populations age and earlier diagnosis and better treatment of the disease lead to improved survival rates. If employers are to continue to provide an environment in which they can attract and retain talented staff, they must take action.

Dutra, Lauren M.; Stanton A. Glantz, Nadra E. Lisha, Anna V. Song. "Beyond experimentation: Five trajectories of cigarette smoking in a longitudinal sample of youth." February 9, 2017.

The first goal of this study was to identify the most appropriate measure of cigarette smoking for identifying unique smoking trajectories among adolescents; the second goal was to describe the resulting trajectories and their characteristics.

Tobacco-induced disease remains the leading preventable cause of death in the United States, with minorities bearing a disproportionate burden of the disease burden. Because 80% of adult smokers begin smoking before age 18, tobacco control efforts often focus on preventing adolescents from smoking their first cigarette. However, only one-third of youth who experiment with cigarettes ever become regular smokers. As a result, these programs miss a key opportunity to prevent the transition from experimentation to established smoking, which may occur in the mid-to-late 20s. In combination with growing recognition that young adulthood (ages 18 to 25) is a critical period of vulnerability, particularly due to significant life changes such as starting college, separating smokers into different trajectories (patterns of smoking) and identifying when escalation and de-escalation occurs can inform efforts to prevent transition to regular smoking.

"Cancer Facts and Figures 2017." American Cancer Society, January 2017.

Estimated numbers of new cancer cases for 2017, excluding basal cell and squamous cell skin cancers and in situ carcinomas except urinary bladder.
Estimates are not available for Puerto Rico.

Note: State estimates are offered as a rough guide and should be interpreted with caution. State estimates may not add to US total due to rounding.

2016

Elissa Meites, MD; Allison Kempe, MD; Lauri E. Markowitz, MD. "Use of a 2-Dose Schedule for Human Papillomavirus Vaccination — Updated Recommendations of the Advisory Committee on Immunization Practices." Centers for Disease Control and Prevention, December 16, 2016.

This report provides recommendations and guidance regarding use of HPV vaccines and updates ACIP HPV vaccination recommendations previously published in 2014 and 2015

"E-cigarette use among youth and young adults : a report of the Surgeon General.." U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, December 8, 2016.

This report confirms that the use of electronic cigarettes (or e-cigarettes) is growing rapidly among American youth and young adults. While these products are novel, we know they contain harmful ingredients that are dangerous to youth. Important strides have been made over the past several decades in reducing conventional cigarette smoking among youth and young adults. We must make sure this progress is not compromised by the initiation and use of new tobacco products, such as e-cigarettes. 

Maki Inoue-Choi, PhD, MS; Linda M. Liao, PhD, MPH; Carolyn Reyes-Guzman, PhD, MPH; Patricia Hartge, ScD; Neil Caporaso, MD; Neal D. Freedman, PhD, MPH. "Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health–AARP Diet and Health Study." JAMA Internal Medicine, December 5, 2016.

A growing proportion of US smokers now smoke fewer than 10 cigarettes per day (CPD), and that proportion will likely rise in the future. The health effects of smoking only a few CPD over one’s lifetime are less understood than are the effects of heavier smoking, although many smokers believe that their level is modest.

Berko, Jeff MPH; Goetzel, Ron Z. PhD; Roemer, Enid Chung PhD; Kent, Karen MPH; Marchibroda, Janet MBA. "Results From the Bipartisan Policy Center's CEO Council Physical Activity Challenge to American Business." Journal of Occupational & Environmental Medicine, December 2016.

Physical inactivity is a major public health threat: inactive adults are at an elevated risk of early death, heart disease, stroke, type 2 diabetes, and depression. Despite these dire consequences, fewer than half of American adults meet the recommended guidelines for daily physical activity. Sedentary jobs contribute to this problem, but the workplace also presents an opportunity for intervention. 

Bergouignan, Audrey , Kristina T. Legget, Nathan De Jong, Elizabeth Kealey, Janet Nikolovski, Jack L. Groppel, Chris Jordan, Raphaela O’Day, James O. Hill and Daniel H. Bessesen. "Effect of frequent interruptions of prolonged sitting on self-perceived levels of energy, mood, food cravings and cognitive function." International Journal of Behavioral Nutrition and Physical Activity, November 3, 2016.

While physical activity has been shown to improve cognitive performance and well-being, office workers are essentially sedentary. We compared the effects of physical activity performed as (i) one bout in the morning or (ii) as microbouts spread out across the day to (iii) a day spent sitting, on mood and energy levels and cognitive function.

Song, Mingyang, MD, ScD; Edward Giovannucci, MD, ScD. "Preventable Incidence and Mortality of Carcinoma Associated With Lifestyle Factors Among White Adults in the United States." JAMA Oncology, September 1, 2016.

Lifestyle factors are important for cancer development. However, a recent study has been interpreted to suggest that random mutations during stem cell divisions are the major contributor to human cancer. 

Conclusions and Relevance: A substantial cancer burden may be prevented through lifestyle modification. Primary prevention should remain a priority for cancer control.

Michael C. Fiore, MD, MPH, MBA. "Tobacco Control in the Obama Era — Substantial Progress, Remaining Challenges." New England Journal of Medicine, August 24, 2016.

The steady decline in smoking rates among U.S. adults that began in the early 1960s has acceleratedsubstantially during the 7 years of the Barack Obama presidency.

Moore, PhD, Steven C. MPH; I-Min Lee, MBBS, ScD; Elisabete Weiderpass, PhD; et al. "Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults." Journal of the American Medical Association , June 2016.

Importance  Leisure-time physical activity has been associated with lower risk of heart-disease and all-cause mortality, but its association with risk of cancer is not well understood.

Objective  To determine the association of leisure-time physical activity with incidence of common types of cancer and whether associations vary by body size and/or smoking.

Steven C. Moore, PhD, MPH; I-Min Lee, MBBS, ScD; Elisabete Weiderpass, PhD; et al. "Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults." Journal of the American Medical Association , June 2016.

Importance  Leisure-time physical activity has been associated with lower risk of heart-disease and all-cause mortality, but its association with risk of cancer is not well understood.

Objective  To determine the association of leisure-time physical activity with incidence of common types of cancer and whether associations vary by body size and/or smoking.

"Winning With Wellness." US Chamber of Commerce, May 5, 2016.

Compelling evidence exists that wellness programs work and prevention pays off when done well and in the right ways. This publication delineates the attributes of successful and effective workplace wellness programs, discusses how workplace wellness can be a win-win for employers and employees, and outlines the legal and regulatory parameters associated with such programs. Significant converging financial, political, and cultural trends drive the importance and the urgent need for more pervasive employer-driven, evidence-based workplace wellness initiatives.

Azvolinsky, Anna . "Unraveling How Obesity Fuels Cancer." Oxford Academic, Journal of the National Cancer Institute, April 2, 2016.

“We are getting more and more precise about the different risk factors for the various subtypes of cancer,” said Stephen Hursting, Ph.D., M.P.H., professor in the department of nutrition at the University of North Carolina at Chapel Hill. One established factor is obesity, now well linked to at least ten cancers, including pancreatic, colorectal, endometrial, and hormone receptor–positive, postmenopausal breast cancer. 

American Cancer Society. "Cancer Treatment & Survivorship Facts & Figures 2016-2017." Atlanta, January 2016.

Cancer Treatment & Survivorship Facts & Figures, a report produced in collaboration with the National Cancer Institute, provides current and future cancer prevalence estimates for the United States, as well as information about treatment patterns, survival, and common concerns for the most prevalent cancers, including side effects of treatment. More than 15.5 million Americans with a history of cancer were alive on January 1, 2016, not including carcinoma in situ (non-invasive cancer) of any site except urinary bladder, and not including basal cell and squamous cell skin cancers. 

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