In a frank message to the public, health experts are emphasising the crucial role of regular cancer screenings in saving lives. The sooner cancer is detected, the higher the chance of successful treatment.
A significant report published in Nature Reviews Clinical Oncology, has drawn attention to a worrying trend: a sharp rise in cancer cases among adults under 50.
Researchers at Brigham and Women's Hospital in Boston are concerned this could signal an emerging global health crisis.
As the world observed World Cancer Day on February 4, recent data from Discovery Health Medical Scheme (DHMS) revealed some positive news amidst this serious concern.
After a decline in cancer screening rates during the Covid-19 pandemic, numbers have bounced back, nearly reaching the levels seen before the pandemic hit.
The setback in cancer screening was not unique to South Africa. Dr Noluthando Nematswerani, the Chief Clinical Officer at Discovery Health, cited a report from the Lancet Oncology Commission titled, “European Groundshot – Addressing Europe’s Cancer Research Challenges”, which estimated that around 100 million missed screenings across Europe could mean that as many as one million citizens are living with undiagnosed cancer because of the pandemic.
Adding to the discussion, Shirley Collie, the Chief Research Actuary for Discovery Health, shared insights from DHMS claims data on the four most common cancers.
The trends observed in this data underscore the necessity for individuals to stay vigilant about their health, and to prioritize regular screenings.
Breast cancer
Breast cancer remains the most common type of cancer among members of the Discovery Health Medical Scheme (DHMS). Yet, with the advent of Covid-19 in 2019, breast cancer screenings saw a significant drop of 19.3%.
There was also a slight recovery the following year - by 2023, the numbers not only bounced back but exceeded pre-pandemic rates by 8.1%, with 367.7 screenings per 1,000 people eligible for the test, a marked improvement.
Prostate cancer
For prostate cancer, the second most common among all DHMS members and the top one among males, the pandemic similarly caused a decrease in screening rates, with a 10.7% fall between 2019 and 2020.
However, by 2021, the screening numbers had recovered to 637.6 per 1,000 eligible members, surpassing the levels seen before the pandemic by 10.4%.
Colorectal cancer
On the colorectal cancer front, the third most common among DHMS members, there was a 15.2% decrease in screenings from 2019 to 2020.
Nevertheless, colorectal cancer screenings also returned to pre-pandemic numbers, with a 24.4% increase in 2023 over 2019 rates. Despite these gains, the percentage of screenings remains low compared to the global average of more than 45%.
In fact, as of September 2023, there were still 787,405 DHMS members eligible for screening who had not been tested. This equates to an alarming 964 missed screenings per 1,000 eligible individuals.
It's important to remember that colorectal screening is a newer addition to DHMS's preventative measures, which may partly explain the lower figure. Internationally, this type of screening isn't embraced as widely as others.
Cervical cancer
For cervical cancer, the trend hasn't been as positive. There has been a consistent drop in screenings, including Pap smears and HPV tests, from 2016 to 2019. The decline sharply intensified in 2020 with a 20% reduction compared to the previous year.
Although there was some improvement between 2021 and 2023, the screening numbers haven't fully recovered to what they were before the pandemic.
In 2023, there was a 13.8% increase in screenings from 2020, with 512 out of 1,000 eligible women getting screened.
According to Collie, an uptick in cancer cases had been noted, which underlined the critical importance of returning to regular screening schedules to detect these illnesses at a stage when they are more treatable.
According to Dr Nematswerani, there was an increase in the number of DHMS members diagnosed with various types of cancer from January to October 2023, compared to the same period in 2022.
The increase includes a 2.7% rise in breast cancer diagnoses, a 17% increase in cervical cancer diagnoses, an 8.6% increase in prostate cancer diagnoses, and a 1.8% increase in colorectal cancer diagnoses.
In terms of age range, members claiming cancer treatments in this period ranged from 23 to 98 years for breast cancer, 25 to 82 years for cervical cancer, 19 to 96 years for prostate cancer, and 17 to 94 years for colorectal cancer.
These increases in cancer diagnoses have led to extensive financial payouts from DHMS.
From January to October 2023, more than R3.2 billion was allocated for cancer treatment and ongoing therapy, which is a substantial increase from the R2.7 billion paid out in the previous year during the same period.
Notably, 0.11% of members, totalling 58 individuals, received payouts of over R1 million for their cancer-related treatments, the highest of which was R1.8 million for a patient with Multiple Myeloma in 2023.
In comparison, 0.05% of members, totalling 25 individuals, had similar high-value claims in the preceding year.
“This is a 7.76% increase in members claiming for cancer treatment and maintenance therapy between 1 January and 31 October 2023 compared to the same period in 2022 from the oncology benefits,” said Nematswerani.
There was, he said, a “Higher survival rate among those diagnosed with early-stage cancer”
“Similarly, a person diagnosed with early-stage prostate cancer has more than a three times higher five-year survival rate (99%), than someone diagnosed at a late stage (31% five-year survival rate).
“And, for someone aged 40, detecting this sort of cancer at an early stage improves life expectancy by 35 years.”
“Then, 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, catching this cancer at an early stage improves life expectancy by 22 years.”
“It is encouraging to note that there is evidence which shows that early-stage cancers are more easily and successfully treated than late-stage cancers. The earlier you catch cancer, the better your outcomes. With this in mind, regular cancer screening is lifesaving,” said Nematswerani.