Real Conversations: Cancer
02 October 2017
Cancer is the most claimed-for critical illness, averaging 60% of claims across UK providers. See how putting the right protection in place can help your clients.
If spotted early enough, the likelihood of surviving cancer is now better than ever, but need for protection has also never been greater, writes Debra Hale
It can be hard to be positive about cancer, but thankfully many of the more common cancers of this dreadful disease are no longer the terminal illness they were even a decade ago.
One in two of us will have a cancer in our lifetime, but more than half of cancer sufferers will now survive more than ten years. This is a dramatic improvement and people now live nearly ten times longer after their cancer diagnosis compared to the early 1970s when the median survival time after diagnosis was just one year.
With deaths from the usual suspects such as heart disease and stroke on a steady decline since the 1950s, cancer mortality has remained constant and this figure is expected to go up.
The main contributing factors are the ageing population and the rapidly growing obesity problem in the UK; some of the unhealthier lifestyle choices can undoubtedly increase the likelihood of getting cancer.
There is a concerning difference between income groups. Factors typically associated with lower income such as smoking, excess alcohol consumption and poor diet mean that cancer survival rates tend to be lower among patients in lower income groups than those in more affluent groups.
Interestingly, the UK is way behind Europe and the US for most cancer survival rates. Our priorities in the UK are skewed, according to the latest Drewberry protection survey: only 10.9% of their 3,000 respondents have critical illness cover.
Sadly, the death rates for some of the more serious cancers such as pancreatic or liver cancer are also on the rise, but death rates for most lower graded, more common cancers are on the decline.
SURVIVING BREAST CANCER
Let’s consider one of the most common – breast cancer. Breast cancer survival in the UK has doubled since the 1970s. Then, four in ten women diagnosed with breast cancer survived the disease beyond ten years. Now it’s about eight in ten and 65% survive the disease for 20 years or more.
These huge improvements have been highly influenced by both the introduction of NHS breast screening in 1988 for women aged 50 to 64 years and widespread use of the drug Tamoxifen.
Mortality from breast cancer peaked in the mid-80s with the UK rate being one of the highest in the world, but with the introduction of screening, mortality rates had fallen by more than 20% by 1999.
When diagnosed at its earliest stage, most women with breast cancer will survive for five years or more, but this reduces massively to just over one in ten when the disease is diagnosed at the latest stage.
Cancer survival generally is higher for younger patients, but breast cancer in women is the exception as survival rates are higher among older patients, again a result of the availability of screening for older women.
Changes in diagnosis and survival rates have led to improvements in Zurich’s underwriting views.
There is a gradual moving away from traditional all or nothing type of provision to a more pragmatic approach to covering cancer conditions and changes to how the industry pays out on these conditions.
Just four years ago, a client with stage one ductal carcinoma of less than 2cms with four to five years since diagnosis would have been a straight decline for critical illness cover, but nowadays we would apply a 50% loading and an exclusion for breast cancer. Life cover would be covered at standard rates.
Medical terminology can be confusing, so for clarity ductal means the cancer starts inside the milk ducts, carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and in situ means ‘in its original place’.
Clients who buy critical illness cover can now have a policy that will pay out a partial or an additional lump sum even if the diagnosis is a carcinoma in situ and fully treatable.
Some traditional plans will still only pay out if the cancer is diagnosed at a more serious stage.
Medical advancements and scientific progress mean that cancer can be spotted earlier and treated. So it’s important to ensure that your clients have the most up-to-date policies and features that can allow them to claim at an earlier stage.
Most critical illness policies now offer partial or additional payments. This means that your clients are more likely to make a successful claim when their cancer is at a less severe stage than would normally trigger a full benefit payout.
Partial payments will be deducted from the main sum assured whereas additional payments will not.
Some of your clients may have older critical illness policies so it may be a good time to review those policies although some of the older-style contracts can offer more comprehensive cover and will pay out for situations that are now routinely excluded.
Whilst it’s good news that more of us are surviving cancer, unfortunately there are other issues presenting beyond the survival and around 25% of cancer sufferers in the UK experience ill health post treatment. Surviving cancer can be a stressful experience for both the patient and their families and one of the main presenting illnesses is depression.
We aspire to support your clients through the claim process with compassion and understanding. They may need help in adjusting to life as a cancer survivor, as may their loved ones. Zurich support services gives them access to varying areas of support in these difficult times.
Debra Hale is a protection specialist at Zurich
CANCER IN NUMBERS
Cancer is the most claimed critical illness averaging 60% of claims across UK providers1
In 2014, there were 361,216 cancer cases diagnosed compared to 289,841 marriages and 271,050 births to first-time mothers2
The number of people living with cancer in the UK is increasing by 3% every year3
The number of cancer survivors in the UK is expected to rise by around 1 million per decade from 2010 to 2040, resulting in 4 million people living with cancer in 20303
Sources: 1 criticalillness.org.uk; 2 Macmillan Cancer Support; 3 Maddams J, Utley M, Møller H. Projections of cancer prevalence in the United Kingdom, 2010-2040