Presidential Cancer Panel Calls For Employer Commitment

Employers, medical insurers, and health care providers can help reduce the rates of cancer and other serious illnesses among workers by offering preventive care and wellness programs designed to promote good health behaviors, the newly released annual report by the President’s Cancer Panel concluded. The report warned that cancer treatment costs and produtivity losses will continue to escalate unless organizations, institutions, and individuals do more to address factors known to affect cancer risk, especially obesity, poor diet, lack of physical activity, and smoking.

The President’s Cancer Panel was established to appraise the National Cancer Program operated by the National Cancer Institute of the U.S. Department of Health and Human Services. Currently, the three panel members are Dr. LaSalle D. Leffall, Jr., M.D.; Margaret L. Kripke, Ph.D.; and cyclist Lance Armstrong.

While acknowledging the important role of laboratory-based cancer detection and treatment research in combating and preventing the disease, the panel noted that relatively few resources flow into behavioral, policy, and environmental interventions that address the principal causes of lung and other types of cancers.

The panel observed that health care providers and insurers, as well as employers, are strongly oriented to the provision of acute care, not to helping people remain well. The report cited the “short-term profit mentality of publicly-held private insurers and many corporations” as a major barrier to coverage for behavioral and other cancer risk-reducing interventions, noting that employee turnover has made both insurers and employers hesitant to invest in preventive interventions.

On the other hand, the panel praised the employee wellness programs that growing numbers of employers are implementing in an effort to cut healthcare costs and limit productivity losses due to illness. In particular, the panel lauded the CEO Cancer Gold Standard program developed by the CEO Roundtable on Cancer. The program accredits employers that maintain a culture that encourages healthy lifestyles and provides services related to tobacco use, diet and nutrition, physical activity, screening and early detection, and access to quality treatment. However, the panel said, many millions of workers continue to lack access to wellness services, particularly those in part-time or low-paying jobs.

With a growing body of evidence linking physical inactivity to an increased risk of certain types of cancer, heart disease, and a host of other serious illnesses, many employers are encouraging their employees to exercise more, the report said. In addition to providing on-site workout facilities or subsidized gym memberships, the panel found that a small number of employers are experimenting with altering work environments to promote physical activity. At some of these companies, the report said, conventional desks are replaced with standing desks, or even with treadmills or stationary bicycles with workstations attached.

The panel noted, however, that most health insurers do not reimburse primary care providers for counseling patients about the importance of physical activity, and relatively few health plans include coverage for gym memberships or premium reductions for participants who exercise.

According to the report, research has demonstrated a strong link between obesity and cancer, while a number of studies have suggested that cancer risk can be lowered by consuming a diet low in animal fat and high in fruits and vegetables. But for the most part, the panel observed, the links between cancer, diet, and obesity have not yet been sufficiently accepted by the insurance industry to motivate widespread coverage for services such as nutrition counseling or obesity-related treatment services. And, they said, while larger employers with self-funded health plans are starting to provide coverage for diet- and weight control-related wellness programs, many smaller employers have fewer options for including wellness programs in their benefit packages.

Despite the current lack of incentives, the panel recommended that employers consider taking a few simple and relatively affordable steps to encourage better health behaviors among employees. These include replacing unhealthy cafeteria and vending machine foods with more nutritious alternatives, giving employees time to exercise, and expanding smoke-free policies in the workplace.

“Research has shown that adopting a healthy lifestyle is an effective defense against cancer,” the panel members asserted in a letter to the president that accompanies the report. “While public and private organizations must coordinate efforts to educate the American public about the relationship between healthy behaviors and disease prevention, individuals can only adopt healthy lifestyles if they have the resources and opportunities to do so.”