Dr Hantel on Environmental and Health Impacts of Decentralizing Cancer Care

Andrew Hantel, MD, physician, Dana-Farber Cancer Institute (DFCI); instructor, medicine, Harvard Medical School, discusses findings from an evaluation of the environmental and health impacts of decentralizing cancer care in response to high emissions generated by United States health care.

At the 2024 ASCO Annual Meeting, investigators reported that, in the initial phase of this study, patient care at DFCI was compared both before and during the COVID-19 pandemic, Hantel begins. The emissions generated by in-person visits prior to the pandemic were significantly reduced with the telemedicine-focused approach implemented during the pandemic, he reports.

Further, investigators conducted a hypothetical analysis, assuming the most decentralized care possible during the pre-pandemic period, and extrapolated the results on a national scale, Hantel continues. This approach revealed a reduction in emissions of approximately one-third, resulting in an estimated annual decrease of 72,171,554 kgCO2e. Although this is a figure that many professionals in the oncology field might not be familiar with, Hantel says investigators translated this data into a more relatable measure—human lives lost due to these emissions. The analysis showed that the excess deaths attributable to these emissions were minimal each year. Although the amount of CO2 reduction was substantial, the associated health risks were relatively low, he adds.

Regarding the future implications of this study, the examination highlights the need to balance the potential harms and benefits of different approaches to patient care, he states. The findings may influence decision-making, particularly in situations where there is uncertainty about the best course of action, he explains. Knowing that in-person care may contribute to downstream health risks due to associated emissions, health care providers might be more inclined to favor telemedicine or decentralized care when appropriate, according to Hantel. This shift could lead to better overall health outcomes by reducing the need for patients to visit health care facilities in person for all their care, Hantel concludes.