^{Abby Kim, PharmD, BCOP, is senior director, clinical strategy and oncology specialty solutions at Prime Therapeutics. She is the co-author of Oncology Insights, a monthly column that shares the latest in cancer care.} 

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Cancer is no longer a condition primarily associated with older age. Across the United States and around the globe, rates of early-onset cancer are rising sharply, particularly in adults under the age of 50. It’s a devastating diagnosis when it comes to health impact and financial cost. According to the American Cancer Society, about 40% of cancers newly diagnosed in U.S. adults are avoidable.  

This demands urgent attention from health plans, providers, employers and policymakers alike. 

Prime is committed to staying atop the latest trends in cancer care. In a recent Oncology Trends webinar, we discussed the evolving cancer landscape, data-driven insights, contributing factors to early detection, unique challenges for younger patients and the implications for managed care. With the right tools — especially improved screening and early detection strategies — many of these cancers can be caught earlier, when treatment is more effective and less costly.  

February is National Cancer Prevention Month, which raises awareness to how cancer is an often preventable condition. Besides certain lifestyle modifications — such as not smoking, limiting alcohol, protecting skin, receiving recommended vaccinations, staying active and eating healthy — screenings play an important role in cancer prevention and detection.  

So, what are the tools that can help detect cancer sooner? And how can payers and providers play a role in championing better overall care?    

Conditions driving the early-onset surge  

Together, colorectal, breast, uterine and kidney cancers account for 80% of the increase in early-onset cases.  

1. Colorectal cancer is rising in adults aged 30–49, prompting the recommendation for screening beginning at age 45 instead of 50. However, preventive screening is only effective when patients actually follow through on their recommended screenings, and adherence among younger adults remains low.  

2. Breast cancer is increasing in adults aged 15–29, well below the recommended screening age of 40. These cancers are often detected after symptoms appear, which leads to more intensive and expensive treatment. Many experts recommend women under 40 do self-evaluations and be aware of any changes that may prompt screenings. Successful tests such as breast tomosynthesis, introduced in 2011, help improve breast cancer identification. Recently updated guidelines for dense breast tissue are also enabling more accurate detection.  

3. Uterine cancer incidence and mortality are rising across all early-onset groups. Unlike breast or colorectal cancer, no preventive screening exists, placing even more emphasis on symptom awareness and timely access to care.  

4. Kidney cancer is increasing in adults aged 30–49, though mortality is improving, thanks in part to incidental detection through imaging and earlier intervention.  

Emerging tools: From artificial intelligence (AI) to Multi-Cancer Early Detection (MCED) testing  

Artificial intelligence is transforming cancer prevention by helping health systems analyze electronic medical records and identify patients who are at higher risk, overdue for screening or need a follow-up appointment after abnormal results. By closing care gaps, improving adherence and reducing late-stage diagnoses, AI-driven tools play a critical role in improving outcomes and lowering costs.  

Another promising innovation is multi-cancer early detection (MCED) testing. These tests use blood samples to detect multiple cancer types simultaneously by identifying tumor-derived DNA or other biomarkers. While MCED tests are not yet approved by the U.S. Food and Drug Administration (FDA) payers must be prepared to evaluate these tests quickly once approved, update coverage policies and integrate them into primary care and preventive pathways. 

According to a recent report in partnership with Exact Sciences, about 6 in 10 health systems offer MCED or plan to offer testing in the next year. Many health systems, almost half, expressed concerns about equity, as MCED tests — which can identify cancers that currently lack screening methods, such as uterine cancer — are expensive, often hundreds of dollars.  

What this means for payers 

Cancer diagnoses are common as people age. As members transition to Medicare, where cancer diagnoses are often made, there is the potential for significantly increased oncology spend. And, as more people are diagnosed sooner, there’s also the potential for an increase in Commercial oncology spend as well. Payers must respond with proactive strategies that include oncology case management, care navigation and digital tools to close gaps and improve coordination.  

First, investing in early detection is critical: Data shows catching cancer just one stage earlier can reduce treatment costs by about $50,000 per year, triple survival rates and avoid late-stage regimens that can exceed $250,000. For example, annual treatment costs for colon cancer jump from $79,000 at Stage I to $272,000 at Stage IV — a more than threefold increase. Prime’s holistic approach to cancer care integrates multiple Prime solutions — spanning analytics, digital support and navigation services — to help reduce oncology spend and enhance patient outcomes. 

Payers must also stay agile as screening guidelines evolve, aligning policies with updated recommendations and preparing for new technologies like MCED.  

Leveraging data and AI can identify rising-risk members earlier, increase screening adherence and reduce unnecessary variation in care.  

Finally, supporting comprehensive cancer pathways is essential for younger adults, who need holistic care that includes mental health support, fertility preservation and long-term survivorship planning. These components not only improve member satisfaction and enhance outcomes but also help reduce downstream costs. That’s where Prime’s IntegratedRx® – Oncology platform comes into play. By putting providers and pharmacists on the same care team, patients are better supported with clear communication, better and more timely care, and access to lower-cost treatments.  

Playing a role in cancer prevention 

We’re not just seeing more cancer; we’re seeing it earlier and in more aggressive forms. Payers have a critical role to play in reversing these trends. By investing in early screening, AI-enabled identification, evidence-based coverage policies, novel screening technologies like MCED and robust care navigation and survivorship programs, we can enhance patient outcomes, mprove member satisfaction and help reduce long-term oncology spend.  

Early detection isn’t just good medicine — it’s good strategy. 

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Learn more about Prime’s oncology solutions