The latest claims data from Discovery Health Medical Scheme shows an improvement in cancer screening rates following the dip during the pandemic years 2020 to 2022. For the most part they have returned to pre-pandemic levels.
“It isn’t only in South Africa that cancer screenings were missed during the Covid-19 pandemic. A Lancet report estimated that due to 100 million screenings missed in Europe, one million European citizens may have undiagnosed cancer,” said Dr Noluthando Nematswerani, the chief clinical officer at Discovery Health.
Screening rates
Shirley Collie, the chief research actuary for Discovery Health, said the trends seen in the screening data regarding the top four prevalent cancers were:
• Breast cancer: Breast cancer is the most common cancer among scheme members. From 2019 to 2020, the first year of Covid-19, breast cancer screening rates decreased by 19.3%. There was a slight increase from 2020 to 2021. By 2023, screening rates exceeded 2019 rates by 8.1%.
• Prostate cancer: This is the second most common cancer for scheme members in general and the most common cancer among men. Prostate screening rates fell during the first year of the pandemic, dropping by 10.7% between 2019 and 2020. There was a recovery in screening rates in 2021 – to 10.4% higher than pre-pandemic levels.
• Colorectal cancer: The third most prevalent cancer among members showed a decrease in screening rates of 15.2% from 2019 to 2020. The rates have recovered to above pre-Covid levels, with a 24.4% increase in 2023 compared with 2019. However, the percentage is still low relative to the global screening rate of above 45%.
• Cervical cancer: A steady decrease in screenings for cervical cancer, namely pap smears and the Human Papilloma Virus test, was noted in the period 2016 to 2019. In 2020, the screening rate decreased sharply, by 20% compared with 2019. There was an improvement between 2021 to 2023, but rates are not back up to pre-pandemic levels. The screening rate increased by 13.8% from 2020 to 2023, Collie said.
Increase in cancer cases
Nematswerani said that Between January and October 2023 compared to the same period in 2022, there was a 2.7% increase in scheme members diagnosed with breast cancer (1 843 members compared with 1 795 members in 2022), a 17% increase in cervical cancer (122 members compared with 104), a 8.6% increase prostate cancer (1 972 members compared with 1 815), and 1.8% increase in colorectal cancer (784 members compared with 770).
The age range of members claiming for cancer treatments between January and October 2023 was 23 to 98 years old (breast cancer), 25 to 82 years old (cervical cancer), 19 to 96 years old (prostate cancer), and 17 to 94 years old (colorectal cancer).
Survival higher if caught early
Data from the Discovery Vitality HealthyFutures model and from the US-based Surveillance, Epidemiology, and End Results Program show that, on average, someone diagnosed with early-stage breast cancer, has a 2.3 times higher likelihood of survival for five years – amounting to a 96% five-year survival rate. On the other hand, there is a 41% five-year survival rate for those diagnosed with late-stage breast cancers.
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.”
Those diagnosed with early-stage colorectal cancer have a 93% five-year survival rate, compared with 25% for late-stage colorectal cancer. For a 40-year-old, catching this cancer at an early stage improves life expectancy by 22 years.
“The earlier you catch cancer, the better your outcomes. With this in mind, regular cancer screening is lifesaving,” said Nematswerani.
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