Q&A: Rising cancer rates in young people exacerbated by provider shortage
As cancer rates in young people rise across the U.S., oncology providers are facing growing challenges in delivering timely and effective care—made worse by a shortage of clinicians who specialize in cancer treatment.
In two separate interviews with HealthExec, the American Cancer Society (ACS) and on-demand virtual provider service Reimagine Care offer valuable insights into how technology can help address these challenges.
Shanthi Sivendran, MD, Senior Vice President of Cancer Treatment Support at the ACS, discusses the rising incidence of cancer in younger populations and the importance of early detection, while Dan Nardi, CEO of Reimagine, explains how their AI-powered tools and telehealth providers help fill the gaps by simplifying time-consuming supportive services.
Editor's Note: The following interviews were edited for clarity and concision.
HealthExec: What is the ACS seeing in regards to prostate and breast cancer being diagnosed more often in young people?
Sivendran: The ACS's ”Facts & Figures 2025” report estimates that 2,041,910 new cancer cases will be diagnosed in the United States this year—an average of 5,600 diagnoses per day—and 618,120 cancer deaths. We continue to see rising incidence rates for common cancers, including breast cancer in women and prostate cancer—with the steepest increase at 3% per year from 2014 to 2021.
In addition to breast and prostate cancers, the number of new diagnoses of colorectal cancer in both men and women under 65, as well as cervical cancer in women ages 30-44, has also been on the rise.
Is there a broad rise in cancer rates, or just in younger demographics?
There is a rise in specific cancers that are of concern. For instance, progress is lagging for pancreatic cancer, the third-leading cause of cancer death in the U.S. Both incidence and mortality are increasing, and the five-year survival rate for 9 out of 10 people diagnosed with tumors in the exocrine pancreas is just 8%, despite substantial efforts to advance treatment.
As mentioned earlier, incidence rates continue to climb for common cancers such as female breast cancer, prostate, and pancreatic cancer. Additionally, rates are rising for uterine corpus, melanoma in women, liver cancer in women, and oral cancers associated with the human papillomavirus.
What role has increased screening played in these trends in cancer rates, and is increased screening correlated with better outcomes?
The cancer death rate declined by 34% from 1991 to 2022, preventing approximately 4.5 million deaths. This decline is largely due to reductions in smoking, improvements in treatment, and early detection for certain cancers. Early detection through screening enables oncology teams to administer lifesaving treatment when cancer is still potentially curable.
I’m interested in how oncologist shortages in some areas can affect patient care delivery and demand. Any thoughts on what shifts in cancer rates mean for oncologists and their patients? And how can they be better prepared for those shifts?
This is definitely a concerning issue. Oncology practices will need to get more creative to ensure access to cancer care in rural areas. For example, they should look more seriously at cancer care at home or outside traditional clinic settings where appropriate, especially for people who are not within driving distance of an oncology practice. Additionally, continuing to advocate for ongoing access to telemedicine, particularly in rural areas, will be critical.
HealthExec: The ACS told us that with rising cancer rates, there’s an opportunity for virtual provider services and telemedicine to fill the gaps. What is Reimagine doing?
Nardi: There is a growing divide between supply and demand for cancer care. Patients are being diagnosed at younger ages, treatments have improved significantly, and patients are living longer— which is great. However, all of this is adding up to more and more demand for cancer care.
On the supply side, we already have a shortage of oncologists. We're currently 2,000 oncologists short of what we need, and it's predicted to get worse. Med schools aren't keeping up, and fewer people are going into the field. On top of that, burnout is affecting nurses and other roles that are key to care delivery. This all contributes to the growing divide.
Our platform helps fill the gap for the 98% of the treatment journey that happens outside of the clinic walls, combining proactive and reactive support tools. We pair patients with the right level of care—whether that’s from a medical assistant, registered nurse, or an oncology-trained team member—connecting them with the right support at the right time.
With cancer care, you're dealing with care plans tailored to patients based not only on the type of cancer but also on their own background. How does technology support that?
Behind the scenes, we’re building a real-time acuity model. This model takes into account everything about the patient’s diagnosis, demographics, and treatment plan, including the therapy they’re on. We combine this historical data with real-time data from the patient’s interactions with Remi. This allows us to create real-time acuity models, and when needed, connect the patient directly to one of our team members.
We have an AI-based virtual assistant called Remi. It conducts proactive check-ins a couple of times a week and sends out ePRO surveys—electronic patient-reported outcome surveys. For reactive care, Remi helps with symptom management. For example, if a patient had chemotherapy a couple of days ago and it's now midnight, and they're feeling really nauseous, they can reach out to Remi to start a conversation. It's like our digital front door.
Is it an AI chatbot that pulls from medical information to answer questions?
It's all delivered through SMS text; patients have a text-message conversation. We chose texting because it has the lowest barrier to entry. You don't have to deal with apps, versioning, passwords, or anything like that. It's all text-based, and we see very high engagement rates across all different demographics.
We chose this on purpose. Take older patient populations, for example—my grandmother, for instance. She could use the phone and text easily, but she's not going to download an app from an app store or remember a password. Texting is simple and accessible. And for young people, it's something they are accustomed to doing on a daily basis.
What are the HIPAA challenges with conducting a patient encounter through standard text messages?
Patients consent to having conversations over text or sharing some of their PHI. They have the option to either consent or not. If they prefer, they can just use the phone version. It's the same phone number, so they can call instead of texting—whatever they want to do.
The vast majority of the time, it's not like we're sending full medical records. We're definitely not sharing social security numbers or anything like that. It's mostly about their symptoms. When we explain to patients the type of interactions and conversations they’ll have, they usually say, 'Okay, I get it. This makes a ton of sense.' In the end, they don't mind if someone knows they were nauseous at 2 a.m. or something similar.
How do you integrate your oncology clinicians into the teams working at in-person care centers?
When we meet with a cancer center or doctor to develop a plan for their patients, we bring in our own virtual care center team, which includes oncology-trained RNs, MAs, and other advanced practice providers, all of whom are on staff as W-2 employees with Reimagine.
When we partner with clients like Memorial Hermann, City of Hope, or others, we become an extension of their team. We’re white-labeled, meaning that even if one of our team members receives an escalation from Remy in real time, we’ll respond as though we’re part of their care team.
We also chart directly in their EMR, maintaining a single source of truth for the patient’s information. Essentially, we are a true extension of that care team. But because we’re using technology, we can do this in a much more cost-effective way. And that ties back to the core idea of this conversation—this is how we bridge the supply and demand gap in healthcare.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.