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Certain cancers will likely rise exponentially due to COVID-19 screening delays

Key Takeaways Credit: American College of Surgeons Key Takeaways Current cancer diagnoses compared with pre-pandemic rates: Researchers quantified missed…

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Key Takeaways

Credit: American College of Surgeons

Key Takeaways

  • Current cancer diagnoses compared with pre-pandemic rates: Researchers quantified missed diagnoses of lung, breast, and colorectal cancers by comparing observed cancer rates in 2020 with pre-pandemic cancer rates (2010-2019).
  • Potential increase in undiagnosed disease: Incidence rates for all three types of cancer have significantly decreased, suggesting that many patients may currently harbor undiagnosed disease.
  • Importance of screening: Study adds to the growing body of literature on pandemic-related disruptions and serves as a vital reminder to encourage all patients to stay up to date on their recommended cancer screenings.

CHICAGO: Delays in cancer screening during the COVID-19 pandemic will likely cause a significant increase in cancer cases that could have been caught earlier with screening, and may now be diagnosed at later stages, placing an increased burden on an already strained healthcare system, according to a new research article published in the Journal of the American College of Surgeons (JACS).

“While the medical system as a whole experienced an incredible burden from the COVID-19 pandemic, now we’re going to see a much different burden present itself due to delays in cancer screening,” said senior author Teviah E. Sachs, MD, MPH, FACS, an associate professor of surgery at Boston University Chobanian and Avedisian School of Medicine and chief of the section of surgical oncology at Boston Medical Center. “With this study, we sought to illustrate with data how we could forecast these likely future trends related to screenable cancer incidence.”

For the study, researchers at Boston University developed a predictive statistical model to quantify missed diagnoses of lung, breast, and colorectal cancers by comparing observed cancer rates in 2020 with pre-pandemic cancer rates (2010-2019). According to the authors, the study is one of the first to look at the number of missed colon, lung, and breast cancer diagnoses at the U.S. population level, and adds to the growing body of scientific research revealing how pandemic-related disruptions constrained cancer care.

“These are all cancers that have very profound incidences in our patient population across the U.S. They are much better managed and often curable when found early, and devasting when caught late,” Dr. Sachs said. “In addition, these are all screening tests that were likely put off during COVID-19 because they require patients to come into the hospital setting.”

To quantify potential missed diagnoses, the team’s statistical model incorporated data from the National Cancer Database (NCDB), which collects data on more than 70% of all cancer cases in the United States.* To adjust for cancer cases not included in the NCDB, researchers standardized the data to the U.S. population using Census data.

Key findings

The team analyzed data from 1,707,395 lung, 2,200,505 breast, and 1,066,138 colorectal cancer patients. Significant differences between the observed cancer rates in 2020 compared with the historical data from 2010-2019 were noted for all three types of cancer:

  • Colorectal cancer: observed incidence decreased by 18.6%
  • Lung cancer: observed incidence decreased by 18.1%
  • Breast cancer: observed incidence decreased by 14.6%

“The incidence for all these cancers decreased, but there’s no reason to believe that cancer incidence dropped during the pandemic in 2020. The data we observe is not likely due to decreasing incidence rates, but I think more likely reflective of missing cancer diagnoses,” said first author Kelsey S. Romatoski, MD, a general surgery resident at Boston Medical Center. “These missed diagnoses are likely going to lead to delays in treatment and upstaging of disease in the coming years.”

In addition, missed diagnoses appeared to disproportionately affect certain sociodemographic populations, including non-White and Hispanic patients and those treated within the Northeast and West regions of the U.S.

Key messages for practitioners

“For these vulnerable patients, it’s especially important that they stay up to date on their screening so we can detect these missed cancers,” Dr. Romatoski said.

“The data in this paper is an important reminder for practitioners to encourage patients who have delayed their recommended cancer screenings to get screened now,” Dr. Sachs added. “And we encourage patients to ask their primary care physician about recommended cancer screenings. It’s imperative that screenings put off due to the pandemic aren’t delayed any longer.”

Study co-authors are Sophie H. Chung, MD; Kelly Kenzik, MS, PhD; Gordana Rasic, MD, MS; Sing Chau Ng, MS; and Jennifer F. Tseng, MD, MPH, FACS.

This article is published as an article in press on the JACS website. This research was also presented at the Grasberger Research Symposium at Boston University Chobanian & Avedisian School of Medicine, Boston, Mass., March 2023.

Dr. Romatoski and Dr. Chung were supported by the Health Resources Services Administration’s National Research Service Award Grant Number T32HP10028.

The authors do not have any relevant disclosures to report.

Citation: Romatoski K, Chung S, Kenzik K, et al. Delays and Disparities in the Observed Versus Predicted Incidence Rates of Screenable Cancers During the COVID-19 Pandemic. Journal of American College of Surgeons. DOI: 10.1097/XCS.0000000000000772.

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*The NCDB is a joint project of the Commission on Cancer (CoC) of the American College of Surgeons (ACS)and the American Cancer Society ACS). The database collects more than 1.5 million new cancer cases each year, representing more than 70% of all cancer cases in the United States.

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About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 87,000 members and is the largest organization of surgeons in the world. “FACS” designates a surgeon is a Fellow of the American College of Surgeons.

The Journal of the American College of Surgeons (JACS) is the official scientific journal of ACS. Each month, JACS publishes peer-reviewed original contributions on all aspects of surgery, with the goal of providing its readership the highest quality rapid retrieval of information relevant to surgeons.


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Metaverse investments: Opportunities and risks of the trillion-dollar VR market

What are the best metaverse projects that investors should keep on their radar? Cointelegraph Research Metaverse Ranking Awards the top projects

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What are the best metaverse projects that investors should keep on their radar? Cointelegraph Research Metaverse Ranking Awards the top projects

The metaverse continues to expand, with industry giants and upcoming players racing to seize a slice of the potentially trillion-dollar pie. Close to $2 billion was invested in blockchain-based metaverse deals in 2022, according to Cointelegraph Research’s VC database

A 2022 report by McKinsey estimated the metaverse industry to potentially generate up to $5 trillion in revenue by 2030, an estimate overtaken by Citi's forecast of $8 to $13 trillion. These estimations reflect significant growth from the global metaverse market of $65.5 billion recorded in 2022. To realize these optimistic forecasts, the metaverse industry would need to sustain an impressive 85% compound average growth rate.

VC metaverse funding in 2022. Source: Source: Cointelegraph Research.

Investors will never guess which metaverse won Cointelegraph’s 2023 Ranking of Metaverses. This blockchain-based metaverse has over $61 million in value locked in its smart contracts and over 8,000 monthly users. To learn more about the project that enables true ownership of in-game assets and has a deflationary token model, read the report now. 

Download the report on the Cointelegraph Research Terminal.

Stronger than ever

Yet, the metaverse landscape is not without its difficulties. Market cap losses have plagued industry leaders, with Meta, formerly known as Facebook, losing 77% of its market cap equivalent to $800 billion between late 2021 and 2022. As a result, Meta’s CEO, Mark Zuckerberg, plans to eliminate 21,000 jobs in 2023.

Despite setbacks, industry titans like Microsoft, Apple, Nvidia, and Qualcomm are all developing their metaverse strategies. Apple's entry into the metaverse is highly anticipated with its AR/VR headset launch slated for June 2023. Similarly, gaming firms like Epic and Roblox utilized the pandemic lockdown to their advantage, successfully launching metaverse concerts that reached millions worldwide.

In 2022, mergers, acquisitions, and financing in the metaverse realm rose from $13 billion in 2021 to over $120 billion, bolstered by Microsoft's $69 billion acquisition of Activision. This deal had a 7.6x EV/Sales multiple and a 20.2x EV/EBITDA multiple. Although valuation multiples are expected to decrease in line with higher interest rates, investment activities remain robust.

Metaverse marketing efforts. Source: Cointelegraph Research.

Top blockchain metaverse projects are also attracting significant capital. Leading blockchain metaverses measured by market cap include The Sandbox ($1.02 billion), Decentraland ($905 million), and Axie Infinity ($830 million). Year to date (YTD) performance of The Sandbox is 44%. Decentraland’s YTD is 62%. Neither of them surpasses Bitcoin’s YTD retu of 68%.

For investors seeking exposure to the metaverse, ETFs like the Fidelity Metaverse ETF (FMET) and Roundhill Ball Metaverse ETF (METV) offer viable options. However, the new Cointelegraph Research study reveals that a majority of token transactions in metaverse projects result from speculation rather than actual in-metaverse usage, a trend that calls for cautious investment.

The Cointelegraph Research team

Cointelegraph’s Research department comprises some of the best talents in the blockchain industry. The research team comprises subject matter experts from across the fields of finance, economics and technology to bring the premier source for industry reports and insightful analysis to the market. The team utilizes APIs from a variety of sources in order to provide accurate, useful information and analyses.

The opinions expressed in the article are for general informational purposes only and are not intended to provide specific advice or recommendations for any individual or on any specific security or investment product.

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How a neighborhood-focused Baltimore initiative is employing patience, partnership, and resident leadership to drive long-term change

At the corner of North and Cecil Avenues in Central Baltimore sits the newly constructed home of a community-based organization, Roberta’s House, which…

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By Darius Graham

At the corner of North and Cecil Avenues in Central Baltimore sits the newly constructed home of a community-based organization, Roberta’s House, which provides mental health and grief counseling services to residents who may not otherwise get these much-needed services. The building represents a transformational investment designed to bring new life to a vacant block that was previously occupied by rowhomes.

When construction on Roberta’s House broke ground in 2018, the two sides of Cecil Avenue at this corner were divided, both physically and symbolically. The juxtaposition of abandoned rowhomes on one side and hope rising from the ground on the other side, sparked a thought among staff at Baltimore’s Weinberg Foundation: What if this building were to be the start of a ripple of redevelopment and opportunity in the neighborhood?

And so, the revitalization of this one building on this one corner would soon become part of something bigger—a philanthropic-funded effort to improve the health and life trajectory of Central Baltimore residents. This piece tells the story of lessons from the Greenmount Life, Opportunity, and Wellness (GLOW) Initiative, a new effort to concentrate financial and social investment in select neighborhoods that have long experienced underinvestment.

Developing a hyper-local strategy rooted in strength

Created in 1990, The Harry and Jeanette Weinberg Foundation had been funding Baltimore-based nonprofits for 30 years when, beginning in 2018 and following many conversations with stakeholders, the foundation adopted a hyperlocal, place-based strategy (while continuing to provide grants across the Baltimore region). The premise was that by focusing some of the foundation’s financial and social capital in a compact geographic area, it could drive positive outcomes in an even more targeted way. Out of this decision came GLOW.

We knew that one of the most important factors in getting GLOW off the ground was choosing the right area on which to focus our efforts. Several factors led to our selection of four Central Baltimore neighborhoods, Midway, Barclay, Harwood, and Greenmount West, including:

  • Need: Many residents of our target neighborhoods had limited economic opportunity and poor health. Midway, for example, had the highest unemployment rate of any neighborhood in the city, the sixth lowest life expectancy, and one of the city’s highest concentrations of children living in poverty.
  • Concurrent investment: While Baltimore City, despite decades of disinvestment, had designated the area as one of its “Impact Investment Areas,” other major developments, including a large nonprofit makerspace, were already underway or forthcoming in the area. Meanwhile, a coalition of funders had also recently launched the Central Baltimore Future Fund to catalyze commercial redevelopment. We recognized that GLOW would be more successful if it aligned with those efforts.
  • Partners: The area also is home to four public schools and many nonprofits, including Central Baltimore Partnership (CBP), a nonprofit collaborative of over 100 organizations dedicated to the revitalization of Central Baltimore neighborhoods. These partners already had meaningful relationships and capacity that if brought together could help achieve more positive outcomes for the neighborhoods around GLOW’s goals.

With all of this in mind, Weinberg Foundation saw an opportunity to improve Central Baltimore’s economic and public health outcomes by working with CBP to physically transform the four neighborhoods, while placing special emphasis on health and educational outcomes for their residents. In this way, the Foundation was able to tap into existing organizational infrastructure—essentially building from strength instead of building from scratch.

Strong and glowing: From an idea to implementation

The central purpose of GLOW is to mobilize and coordinate an array of organizations to improve the health and life trajectory of Central Baltimore residents by improving access to, and utilization of, primary health care, nutritious food, and enriching educational or career opportunities for youth. While the long-term goal is to make an impact on key indicators like unemployment and life expectancy, we know that those will take years. In the interim, we are squarely focused on supporting the initiative as a platform for aligning multiple organizations, sourcing and advancing residents’ goals and desire, lifting up residents as leaders, and attracting additional resources to the neighborhood.

We’ve had some early wins. For example, GLOW has established a network of more than 30 service providers, including a national organization it recruited to the neighborhood, which will connect 125 families with housing, employment, financial, and supportive services that help increase economic mobility. Other wins include expanding paid summer youth opportunities in the neighborhood by partnering with Banner Neighborhoods to operate a YouthWorks site, and catalyzing the development of several key capital projects including an outdoor education and community health hub along with a teaching kitchen. Along the way, we’ve also learned a lot of lessons relevant for any equity-focused place-based initiative, including:

  1. The lead organization for a place-based initiative—CBP in the case of GLOW—must be adept at navigating a range of efforts and stakeholders. Specifically, it must be capable of both strategic and tactical efforts and have trust and relationships with a range of stakeholders, including funders, government leaders, and residents. The organization must focus on strategy at all levels and not get bogged down in the day-to-day of providing services and activities in the neighborhood.
  2. Genuine partnership means more than ‘partners on paper’. Partnership, like collaboration, is a term that gets used a lot and can mean different things to different people. With GLOW, we have found that true partnership requires more than regular meetings or information sharing. It demands building trusting relationships rooted in an “if you win, I win” mentality instead of in the scarcity mindset that often pervades the nonprofit sector, especially when it comes to working with foundations. It means jointly applying for funding, being clear about expectations and roles, and navigating conflict.
  3. Community leadership is as important as community engagement. For place-based initiatives like GLOW, it’s critical that residents not just be engaged in typical ways like surveys or public meetings. Instead, residents should have genuine leadership and decision-making authority— meaning equal or greater representation on the committee overseeing the initiative, with compensation for their time and insights.
  4. Planning takes time and resources. Place-based initiatives require coordinating across city agencies, nonprofit organizations, and resident leaders—as well as including visible wins in early months to build trust and buy-in with residents and partners. This took us two years and required flexibility as the COVID-19 pandemic extended timelines and shifted our attention. Even under normal circumstances planning requires significant staff time to thoughtfully engage residents and stakeholders in small group and one-on-one conversations.
  5. Patience is essential. Place-based initiatives require a long-term commitment due to the nature of developing the infrastructure across sectors to create systemic, long-term change. Phases include understanding the challenges and opportunities in the community, building the infrastructure across multiple partners, and capacity building for anchor institutions—all before achieving neighborhood-level outcomes.

With these lessons in mind, we are continuing to invest in and build GLOW so it can serve as a platform for convening resident and stakeholders to drive change in Central Baltimore for many years to come. By focusing on strategy, building true partnerships, centering residents as leaders, investing in planning, and operating with a sense of flexibility and patience, we believe other funders and community-based organizations can build similar initiatives to help transform underinvested neighborhoods.

Photo credit: Banner Neighborhoods, Inc.

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Insilico Medicine Founder and CEO Alex Zhavoronkov, PhD presents at Jefferies Global Healthcare Conference

Alex Zhavoronkov, PhD, founder and CEO of Insilico Medicine (“Insilico”), a generative artificial intelligence (AI)-driven drug discovery company,…

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Alex Zhavoronkov, PhD, founder and CEO of Insilico Medicine (“Insilico”), a generative artificial intelligence (AI)-driven drug discovery company, will present on the latest company milestones at the Jefferies Global Healthcare Conference on June 8, 4:30pm ET at the Marriott Marquis in New York City. The conference brings together hundreds of public and private healthcare companies and thousands of executives, as well as institutional investors, private equity investors, and VCs discussing trends and investment opportunities in healthcare in the US.

Credit: Insilico Medicine

Alex Zhavoronkov, PhD, founder and CEO of Insilico Medicine (“Insilico”), a generative artificial intelligence (AI)-driven drug discovery company, will present on the latest company milestones at the Jefferies Global Healthcare Conference on June 8, 4:30pm ET at the Marriott Marquis in New York City. The conference brings together hundreds of public and private healthcare companies and thousands of executives, as well as institutional investors, private equity investors, and VCs discussing trends and investment opportunities in healthcare in the US.

Zhavoronkov will share updates on Insilico’s rapidly progressing pipeline of novel therapeutics available for partnering and licensing, and showcase its new AI-driven fully robotic target discovery and validation platform, and end-to-end drug discovery platform, Pharma.AI, which includes target identification (PandaOmics), drug design (Chemistry42), and clinical trial outcome prediction (InClinico). The platform has produced three drugs that have reached clinical trials. Insilico’s lead drug for the devastating chronic lung disease idiopathic pulmonary fibrosis (IPF), the first AI-discovered and AI-designed drug to advance to clinical trials, will soon be entering Phase 2 trials with patients. Insilico’s generative AI-designed drug for COVID-19 and related variants has been approved for clinical trials and has a number of design advantages over existing COVID-19 drugs. Most recently, the company announced that its USP1 synthetic lethality inhibitor received FDA IND approval for the treatment of solid tumors. 

There are 31 drugs in Insilico’s pipeline available for partnering and licensing for indications including cancer, fibrosis, and central nervous system diseases, and the Company has nominated 12 preclinical candidates in the past two years, most recently a potentially best-in-class preclinical candidate targeting ENPP1 for cancer immunotherapy and the potential treatment of Hypophosphatasia (HPP).

Insilico has partnered with leading pharma companies, including Fosun Pharma and Sanofi, to accelerate their programs. The Company has raised over $400m in funding to date from notable biotech and tech investors.

 

About Insilico Medicine

Insilico Medicine, a clinical-stage end-to-end artificial intelligence (AI)-driven drug discovery company, connects biology, chemistry, and clinical trials analysis using next-generation AI systems. The company has developed AI platforms that utilize deep generative models, reinforcement learning, transformers, and other modern machine learning techniques to discover novel targets and design novel molecular structures with desired properties. Insilico Medicine is delivering breakthrough solutions to discover and develop innovative drugs for cancer, fibrosis, immunity, central nervous system (CNS) diseases, and aging-related diseases.

For more information, visit www.insilico.com

 


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