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If the internet is available in your area, you're more likely to receive an early diagnosis of lung cancer -- and potentially lifesaving care -- says a new nationwide study from researchers at the American Cancer Society.
The study identified 305,198 patients from the National Cancer Database who’d been newly diagnosed with non-small cell lung cancer. The researchers then cross-referenced this with data from Microsoft’s Airband Initiative, which shows the availability of broadband speeds -- 25 megabits per second download and 3Mbps upload at the time -- in each ZIP code.
“We found that increased broadband access, combined with the expansion of telehealth services during the COVID-19 pandemic, was associated with quality of cancer care,” Qinjin Fan, one of the authors of the study, told CNET.
This analysis joins a growing body of research that designates internet access as a “social determinant of health.” The phrase typically refers to things like food, housing and transportation disparities that can lead to differences in life expectancy.
"The delivery of clinical services only contributes 20% to health outcomes -- 40% is what we call socioeconomic status," Carole Myers, a professor at the University of Tennessee in Knoxville who studies health care access and disparities, told CNET earlier this year. "It's things like your income level, your education level and the resources that are available in your community."
The patients identified in this study were initially diagnosed between 2019 and 2021. Researchers tracked treatment stages, such as surgery, chemotherapy, and neoadjuvant chemoradiation, along with the stage at diagnosis.
While this study didn’t evaluate the impact of broadband access on how often patients survived lung cancer, it did track how often patients received recommended care, which has been shown to have a survival benefit.
Telehealth has a major impact on health outcomes
The researchers attributed the earlier diagnosis of lung cancer and enhanced quality of care primarily to telehealth services.
“Broadband access is closely related to the use of telehealth,” Fan told CNET. “This approach benefits both patients and providers by reducing travel distance, time and related costs. We think this is why we found stronger associations for individuals residing in non-metropolitan areas.”
This was especially evident during the COVID-19 pandemic, which saw an unprecedented expansion of telehealth services. Before the pandemic, less than 1% of outpatient appointments were held remotely. More recently, that number has climbed to 8%.
A recent large-scale survey found that 45% of adults believe that inadequate access to technology, including broadband and computers, is a barrier to telehealth. This view was particularly prominent with rural residents and people over the age of 65.
While we might not think of cancer as being treatable over a computer, studies have found that telehealth can save significant time and money during lengthy cancer treatments, with an average savings of $147 to $186 per visit.
“Many of my patients don’t need to come in for postoperative visits,” said Dr. Philippe Spiess, a senior surgeon who co-authored one study on telehealth and cancer treatments. “I expect to use telehealth for these visits as part of my daily practice now and in the future.”
Using the internet might not seem to have a clear link to cancer treatment on the surface, but we’re learning that it’s a foundational aspect of health.
"Broadband access is really important for telehealth," Myers, the professor who studies health care access and disparities, said. “But it's important for economic development, for attracting businesses -- it's important for education. And in turn, those things drive health."