PwC: Closing the Healthcare Gaps in Female-Specific Cancers

Women’s oncology encompasses a wide range of cancers that either occur only in women or disproportionately affect women in incidence, biology or outcomes.

A PwC report analyses women-specific cancers, exploring and addressing the underfunding of diagnoses, treatments and investments.

According to PwC, healthcare leaders can accelerate innovation with the prioritisation of precision medicine, integrating oncological care into a wider range of women’s health initiatives.

Funding female oncology

PwC states that female-specific oncology today stands at approximately US$65bn to US$75bn.

By 2030, it is predicted to reach up to US$110bn, a 7-9% annual growth rate, across diagnostics, therapeutics, devices and care.

Breast, ovarian, endometrial, cervical, vulvar and vaginal cancers are set to represent one of the largest and most consequential segments of women’s health.

PwC states that whilst breast cancer has decades of research and investment behind it, gynaecological cancers tend to face disproportionate funding and research, leading to unmet needs.

Annually, in the US, more than 400,000 diagnoses take place in breast and gynaecological cancers, representing almost half of all female cancer cases.

"For decades, breast cancer has driven much of the innovation and investment in women’s oncology, but ovarian and other gynaecological cancers carry significant unmet need that has gone largely unaddressed: Ovarian cancer receives just US$43,000 in NIH research funding per death, compared with nearly US$70,000 for breast cancer,” says Claire Love, Principal at PwC and Co-author of the report.

“The science is advancing and we now have real opportunities for targeted investment to accelerate that progress and improve outcomes for millions of women impacted by these cancers."  

Exploring female-specific cancers

According to the report, ovarian cancer has the highest mortality rate out of the female-specific cancers; this is likely due to the absence of accurate and early detection.

Within the US, endometrial cancer is the most common gynaecological malignancy and it is predicted to be on the rise.

PwC reports that cervical cancer incidence is declining significantly due to screening uptake; however, younger and underserved women remain disproportionately affected.

It is noted that despite having a higher mortality rate, ovarian cancer receives only a quarter of NIH funding allocated to breast cancer.

Compared to prostate cancers, ovarian cancer receives a third less funding per death, despite having a drastically higher mortality burden.

The report calls for improvement across the patient's journey, including risk identification, fast diagnosis, more targeted treatment and better long-term management.

“There are gaps to close at every stage,” says the report.

Expanding oncology investments

The report states that devices and diagnostics are attracting the largest share of deal volume, encompassing innovations such as AI-enabled mammography and genomic risk platforms to liquid biopsies and surgical guidance tools.

Pharma is capturing the largest share of invested dollars, with the recent acquisition of an ovarian cancer-focused antibody-drug conjugate platform for almost US$2bn.

According to PwC, each sector has a unique investment logic.

Pharmaceuticals

PwC states that pharmaceuticals drive most of the opportunity in women's oncology (70% of market value).

Growth is being led by targeted therapies, replacing chemotherapy and enabling earlier, more tailored intervention.

Successive waves of HER2- targeted therapies, CDK4/6 inhibitors, PARP inhibitors and antibody drug conjugates (ADCs) have created one of oncology’s clearest examples of precision medicine success. 

PwC states that “These advances can increasingly be extended to gynaecological cancers, where therapeutic options remain more limited.”

Ovarian cancer is also seeing progress due to the PARP inhibitor maintenance therapy and emerging ADC’s.

Treatment options for endometrial cancer are also showing promising advancements with personalised immunotherapy, PARP inhibitors and HER-2-directed agents.

Care delivery

Female cancer patients are getting younger, with women before 50 becoming twice as likely to develop invasive cancer compared to men.

Survivorship is becoming more critical, which is why providers are expanding integrated care beyond treatment with: patient navigation programmes, multidisciplinary women's cancer centres and survivorship services for quality of life like post-cancer menopause management and cold caps to minimise hair loss.

Fertility preservation is also becoming a critical and essential consideration for younger patients; due to this, providers are developing more formal oncofertility programmes to aid in counselling and preservation.

Devices and diagnostics

According to PwC, early detection remains the largest unmet need in gynaecological indications due to less advanced diagnostics.

Ovarian cancer is a key example in the report, with more than 60% of cases being diagnosed at advanced stages and outcomes being highly stage-dependent.

The report states that five-year survival drops from more than 90% at stage 1 to roughly 20% at stage 4.

Due to no reliable screening tools, researchers are exploring innovative approaches including circulating tumour DNA (ctDNA), uterine liquid biopsies and AI-enabled multimarker risk models. 

Screening test barriers still exist and providers are looking to reduce challenges linked to traditional clinic-based testing. 

Screening is being brought closer to patients through mobile mammography programmes and community-based initiatives; at-home cervical cancer tests are also being promoted for being less painful and increasing the likelihood of early detection.