10% increase in new cancer diagnosis

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“I was having trouble passing urine,” says, Zephania Msimang. Blood tests revealed prostate cancer. “I thought that the diagnosis was the end of my world as I knew it,” recalls the 60-year-old. “But the urologist and oncologist reassured me that the cancer was in its early stages and that I need not worry.”

Msimang was treated using brachytherapy, in which radioactive pellets are surgically inserted into the affected prostate. In remission, he’s back at his job with a renewed focus on healthy living. “My cancer journey has taught me to trust the experts. It’s helped the people in my community in Katlehong (east of Johannesburg) to see me go through this and come out on the other side, perfectly fine.”  Msimang was overweight before his diagnosis. “I’m losing the weight. I ate very unhealthy food and drank sugary drinks. But now I eat far more vegetables and fruit,” he declares. Msimang adds: “I’ve learnt something that all people need to know - healthy living is key to cancer prevention and screening tests can detect a cancer while it’s highly manageable.”

Key Healthcare Claims Tracker findings include the following:

• There were 7 597 Discovery Health Medical Scheme (DHMS) members newly diagnosed with cancer in 2017 – an increase of 10% since 2011.
• In 2017, 38 295 DHMS members received cancer treatment - an increase of 45% over the past six years. The number of adult men on active treatment is increasing at a faster rate than adult women (4% more men on active treatment in 2017).
• A higher number of cancer diagnoses is seen in older people, (highest in 76- to 80-year-olds).
• From the age of 56, men have a significantly higher rate of new cancer diagnoses (26%) compared with women.
• Between the ages of 35 and 55, rates of new cancer diagnoses are higher in women than men.
• In 2017, the DHMS spent R3 billion on cancer treatments for members.
• Oncology treatment costs increased by 103% between 2011 and 2017.

“The high costs of cancer treatment we’re seeing stem from the increased prevalence of cancer as well as new high-cost treatments,” says Dr Goodman. “The trends also reflect the introduction of new treatments which extend for long durations. The average cost of treatment for a member undergoing cancer treatment has, since 2011, increased by 17% - to R77 644.”

Which cancers top the list for DHMS members?

In 2017, the top cancer by incidence (new diagnoses) affecting male DHMS members is prostate cancer. The top cancer by incidence affecting female DHMS members, is breast cancer. The second- and third-most prevalent newly diagnosed cancers across both male and female members are colorectal and lung cancers.

When it comes to cancer prevalence (members actively claiming for oncology treatment in 2017) member data shows prostate, colorectal and urinary cancers top the list for male members, while breast, colorectal and thyroid cancers top the list for female members. 

Most child DHMS members actively claiming for oncology treatment in 2017 were affected by leukaemia, followed by brain tumours and genito-urinary cancers. The top three cancers in new diagnoses among children were leukaemia, brain tumours and Hodgkin’s Lymphoma.

 “Since 2011, we’ve seen a 13% increase in members newly diagnosed with prostate cancer and a 63% increase in members on active treatment,” says Dr Goodman. "Thankfully, we haven’t seen an increase in diagnoses where the prostate cancer has spread to other parts of the body. That’s thanks to men and their doctors doing 17% more screening tests since 2011, so we’re catching their cancer early on, for better prognoses.”

This resonates with Msimang: “My GP has taught me to get the right health checks for my whole body, not just my prostate. After my brachytherapy treatment, I had blood tests every three months to check my Prostate Specific Antigen (PSA) levels and they progressively dropped. After the last blood tests, in September 2017, the PSA levels were fine. The tumour has shrunk to the point where it has disappeared.”

Turning to breast cancer, the incidence among DHMS members starts to increase significantly for women from age 40 onwards. “The average age of members first diagnosed with breast cancer is 57.5 years old,” says Dr Goodman.  “The number of annually, newly-diagnosed members has remained relatively stable since 2011. Yet, the number of DHMS members receiving active treatment for breast cancer has increased significantly. That’s the result of earlier diagnoses, improved survival rates and members remaining on treatment for a longer period of time,” explains Dr Goodman. “It’s encouraging to see that the number of women undergoing screening tests for breast cancer has increased by 9% since 2011. Yet, more and more DHMS members are being diagnosed with breast cancer that has spread to other parts of the body which means that a large percentage of women are still not going for their screening tests, or they are being diagnosed with more aggressive forms of breast cancer which are difficult to identify, even with regular screening.” Those members diagnosed with a breast cancer that has not spread to other parts of the body are far more likely to have regularly performed screening in prior years.

The number of DHMS members newly-diagnosed with colorectal cancer each year has increased by 14% since 2011 while 52% more members now receiving active treatment for this cancer. The incidence of colorectal cancer peaks between the ages of 76 and 80 years old, however there are members being diagnosed from as young as 16 years of age. “Risk factors for this sort of cancer include obesity, physical inactivity and poor diet,” says Dr Goodman. The proportion of members diagnosed with colorectal cancer that has spread to other parts of the body is significantly greater than in breast cancer and prostate cancer. Colorectal cancer screening tests among DHMS members – though up by 26% since 2011 – remain infrequent compared to breast or prostate cancer screening tests.

Read the full oncology tracker here.

The Discovery Health Medical Scheme is an independent non-profit entity governed by the Medical Schemes Act, and regulated by the Council for Medical Schemes. It is administered by a separate company, Discovery Health (Pty) Ltd, an authorised financial services provider.