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- Discovery Health Medical Scheme's (DHMS) 2023 cancer claims payouts were almost 19% higher in rand terms year on year.
- This amounts to R3.2 billion, with the highest cancer-related pay out being R1.8 million for a patient with multiple myeloma, which affects white blood cells.
- But Discovery warns that screening levels for some cancers haven't returned to pre-pandemic levels, and catching cancer early can help save lives.
- For more financial news, go to the News24 Business front page.
The latest data from Discovery Health Medical Scheme (DHMS) shows the scheme paid out more than R3.2 billion for cancer treatment and maintenance therapy last year.
The data, which covers January to October, represents an increase of nearly 19% year on year, with the highest related payout being R1.8 million for a patient with multiple myeloma, which affects the white blood cells.
Only with 0.11%, or 58, of DHMS members had claims of more than R1 million paid out last year.
During the period, there was a 2.7% increase in DHMS members diagnosed with breast cancer to 1 843 members, as well as a 17% increase in members diagnosed with cervical cancer at 122.
The data also shows an 8.6% increase in members diagnosed with prostate cancer to 1 972 and an increase by 1.8% in diagnoses of colorectal cancer to 784.
DHMS says the likelihood of an individual getting cancer in their lifetime is relatively high, with data from the Global Cancer Observatory in 2020 estimating worldwide lifetime risk of cancer of 25.10%. At 26.27%, men are slightly more at risk than women, who have a risk of 23.96%.
The age range of DHMS members claiming for cancer treatments between January and October 2023 was 23 to 98 years old for breast cancer; 25 to 82 years old for cervical cancer; 19 to 96 years old for prostate cancer; and 17 to 94 years old for colorectal cancer.
"Around 40% of cancer cases could be prevented by adhering to a healthy diet and physical activity," said Dr Noluthando Nematswerani, chief clinical officer at Discovery Health.
She emphasised that cancer which is detected early is often more successfully treated than late-stage cancers, adding:
Data from the Discovery Vitality HealthyFutures model, along with data from the US-based surveillance, epidemiology and end results program (SEER), show that, on average, someone diagnosed with early-stage breast cancer has a 2.3 times higher likelihood of survival over five years. That translates into a 96% five-year survival rate.
Conversely, there is a 41% five-year survival rate for those diagnosed with late-stage breast cancers. At age 40, diagnosing breast cancer at an early stage improves life expectancy by 22 years, relative to later stage 3 and 4 cancer diagnoses.
Similarly, at 99% a person diagnosed with early-stage prostate cancer has more than a three times higher five-year survival rate than someone diagnosed with late-stage prostate cancer.
For someone aged 40, detecting prostate cancer at an early stage improves life expectancy by 35 years, says Nematswerani.
Those diagnosed with early-stage colorectal cancer have a 93% five-year survival rate, compared to 25% for late-stage colorectal cancer. For a 40-year-old, identifying colorectal cancer at an early stage improves life expectancy by 22 years, says Nematswerani.
The importance of cancer screening has been highlighted by a Lancet Oncology Commission report showing that one million people in Europe may have undiagnosed cancer due to screenings that were missed during the Covid-19 pandemic. Fortunately, DHMS says cancer screening rates in SA have, for the most part, recovered.
Pandemic lag
By 2023 screening rates for breast cancer, the most common cancer among DHMS members, exceeded 2019 rates by 8.1%, with 367.7 screens completed per 1 000 eligible person years. The epidemiological concept of "person-years" is a way to measure the amount of time that people in a study have been exposed to a certain risk or condition and assists researchers understand the incidence rate of a disease or event over a given period.
Screening for prostate cancer, the second most common cancer for DHMS members and generally the most common cancer among men, declined in 2020 from 577.5 to 515.5 screens per 1 000 eligible person years, a 10.7% drop from the previous year.
There was some recovery in screening rates in 2021 before testing rates increased to 637.6 screens per 1 000 eligible person years in 2023 – 10.4% higher than 2019 levels.
Colorectal cancer screening rates have recovered to above pre-pandemic levels, with a 24.4% increase in 2023 compared to 2019, which translates to 36.6 screens per 1 000 eligible person years in 2023.
Unfortunately, DHMS said screening for cervical cancer continued to lag. The scheme noted a steady decrease in screenings for cervical cancer from 2016 to 2019, with screenings then suffering a 20% drop in 2020.
While cervical cancer screening improved somewhat from 2021, rates are still not back up to pre-pandemic levels, with just 512 screenings per 1 000 eligible person years.
