Innovative use of health Data for Preventive Action on Cancer

Keywords

Preventive Health Care, Digitalization, Augmented Intelligence, Machine Learning, Behavioral
change, Data usage and safety, Societal Inequality

Focus Area

Every third citizen in Denmark is diagnosed with cancer before age 75. Cancer is responsible for more than 30% of all death causes in Denmark, but it is possible to prevent op to 40% of the cancer cases. The little things we do on a day to day basis has a huge impact on our health and our likelihood of avoiding cancer.

In ’The Department of Prevention’ in the Danish Cancer Society our aim is to reduce the amount of cancer cases in Denmark. Our focus on preventive action against cancer is based on Europe’s cancer codex advice twelve, which describes concrete actions to prevent cancer. The index is based on international research.

We are dedicated to promote and create societal structures and conditions that foster healthy choices. The healthy choices should be the easy choice.

Many of the choices we make today are supported by digital devices, which generates large amount of data. Likewise Denmark has a vast amount of surveys and reports on public health. Our aim is to make all this data available for the individual citizen to reduce the amount of cancer cases to a minimum. We see a huge potential in these data as a key element for citizens to take preventive action.

In the Danish cancer society’s preventive efforts, focus is on three main areas: Culture, Information and Structure. Structural prevention is not in focus in this challenge, as these depends on public policy and community structure. Information and culture, which influences societal norms, on the one hand, and opinions, on the other hand, have a big potential for a digital makeover. Particular the personal preventive actions holds many possibilities for a digital and data based approach.    

Target group: All Danish citizens is the target group. All though strategically two groups distinguish as benefitting the most by preventive action.

We have identified a primarily group to be in higher risk of cancer, which is socially vulnerable. Inequality in health is therefore a primary focus. And maybe a part of this group can be reached through a platform/institution; their workplace (short-term educated) or if they have had contact with the health care system many times because of generally bad health (e.g. other NCD’s as diabetes).

The secondary group is teenagers/youth, for the simple reason that an early adaptation of healthy habits holds the biggest potential for a permanent healthy lifestyle.  

 Why is it difficult to take preventive action? Prevention takes time. As tobacco prices rises in April 2020, it will take many years to be able to measure a change in tobacco related cancer cases. The same applies to a successfully implementation of an alcohol reduction among young people.

Furthermore, the effects of preventive efforts are often jeopardized due to the tendency that solid evidence quickly is neglected in preference for a personal view, perceptions, feelings and wellbeing. The HPV-crises is a perfect example of this, as we saw how it only took a few people to doubt the effect of the vaccine, which started a whole counter-movement against the vaccine.

Challenge

Help us on the journey to develop a new solution or demonstrate how existing digital technologies can optimize healthy choices primarily among the socially vulnerable Danish population to prevent as many cancer cases as possible. Maybe by bringing together fragmented data that contains unused potential.

How can digital innovation contribute to encourage preventive actions? How can we use the emerging state-of-the art tech-solutions to nudge people to take preventive actions against cancer?  Taking into account the target group identify and create the best possible solution that on a day-to-day basis can interact and nudge the user to change behavior. 

 Opportunities:

•  How can we bring back the user-generated health-data-profile for each citizen? How can we use the public health statistics generated in the best possible way? Make use of the most accurate data as possible and be critical in terms of how these are generated, used, stored and owned.
• How can the Danish Cancer Society use it’s unique role in the Danish Healthcare system to start a revolution in how we see and foster preventive actions in health-related matters. 
• We imaging a solution where a device/platform can generate new and multiple unique and precise data-points for each user, hereby supporting a high quality data-backed knowledge-platform from which advice are generated real-time to nudge the person to take preventive action to cancer.  

Barriers:

• Much of the knowledge (hereby raw data) and analysis we generate today is based on self-reported data, which limit the data quality.  Further more some of the knowledge we have available today (2020) among other sources the Danish Cancer Societies own research department – is challenged by the so-called horserace-bias. E.g. it can be almost impossible to decide if people are overweight because they stopped being physically active, or if they are physically inactive because they are overweight.  

     We know the least about the citizens, who are not interested in their own health or do not have the motivation and/or resources to act. Today we do not have easy access to the social vulnerable population group when it comes to their health data. This means there is a potential for better understanding one of the Danish Cancer Society main target groups’ needs and behavior. We, on the contrary, have much knowledge of the user-group (health-conscious) that already are aware of the risk-taking behavior; as they are already using multiple platforms and apps and hereby generating data. The same applies for e.g. cancer
patients, as they are willing to share data to support their recovery. 

Considerations

Could the climate agenda and its dominance in users consious be driving the preventive actions on cancer (for example consumption habits, cigarettes) how can this be exploited digital? The same applies for mental health – we know that mental health influences habits around excersie and diet, can this be taken into account in a digital solution?

Currently digital solutions exists in manifold, like health apps targeting the user-group of health-consious-profiles that already have or want healthy lives. We are looking for a solution for the socially vulnerable or/and for the youth. We have already developed a UV-app and a smoking-cessation tool.  

Data/augmented reality can reveal a lot about lifestyle habits and are accessable on most mobile devices. These include: Activitylevel and performance (sports apps), diet (take-away,
foodboxes), behaviour (Netflix stats, screen-time) Image recognition (smoking/drinking). The data and information that we can generate from these channels we believe can benefit the indivudial but also us as a soceity. But how can we get concent from the user to share personel data with us? And what premisis follows these kind of data, in terms of legal and ethical usage and storeage?

Could a digital device contribute to a more data-backed information campainging. Today we inform and try to change behavior via campaigns, but we have difficulties to measure their effect. Could a digital device intelligent and user-friendly inform citizens on new tobbaco profucton and its safety profile (snuff and e-cigarettes). Could we digitalise
our campaign-tools in such a way that it becomes more interactive and user-oriented. SoMe-activities is a recent example on opportunities to follow directly a user-groups engagement, we do we exploit enough these inherent opportunities.

Can a digital device support the individual to take healthy choices and advice for preventive actions in their own daily behaviour(example  Are you making yourself attractive to cancer but in a smarter way). 

Links/access

1. WHO cancer kodeks http://cancer-code-europe.iarc.fr/index.php/da/
2. Viden om risikoparatmetrene: https://www.cancer.dk/forebyg/
3. Den nationale sundhedsprofil 2017: http://www.danskernessundhed.dk/
4. Rapport om social ulighed i kræft: https://www.cancer.dk/dyn/resources/File/file/6/7826/1551789863/hvidbog_social_ulighed_kraeft_i_danmark.pdf
5. (eller i en kortere version): https://www.cancer.dk/dyn/resources/File/file/7/7837/1551984940/1.1-hvidbog-om-social-ulighed-i-kraeft-i-dk-maja-halgren-olsen-compressed.pdf)
6. Unges sundhed og trivsel 2019 https://www.sdu.dk/sif/-/media/images/sif/udgivelser/2019/rapport_ung19.pdf
7. Skolebørnsundersøgelsen 2018 https://www.hbsc.dk/