Cancer cases rocket – and so does the cost of treatment
The number of middle-class South Africans getting cancer is rising, according to Discovery data
The number of Discovery Health medical aid patients claiming for cancer treatment has increased 99% since 2010.
The medical scheme, which has 2.2 million members, released its annual claims data on Wednesday. The data show the number of middle-class South Africans getting cancer each year is increasing, as is the number of deadly metastatic breast cancers that spread through the body and are harder to treat.
It noted that while the number of Discovery members had increased 24% since 2010, members with cancer had increased four times as much over the past eight years.
The report gave a number of reasons for the increase, including that people join Discovery because they have cancer. It also noted that its middle-class members are getting older, and that cancer risk increases with age.
Some newer medications mean people are treated for cancer for longer periods after surgery, increasing the number of people in the medical aid using cancer medicine each year.
But head of the government cancer registry Dr Elvira Singh said that in the state sector, cancer in general is not rising among government patients.
“Reporting of cancer cases to the registry became compulsory in 2011 so most of the increases we have seen are because every cancer case in the country is being recorded. It is better reporting, not more cancer.”
She said conjunctival cancer, an eye cancer linked to HIV, had increased since 2011.
In addition, because “the white population is ageing in South Africa it would have rising cancer rates”.
The registry analyses cancer rates based on race, socio-economic status and age, to improve understanding of the causes and prevention of cancer.
Among black women breast cancer rates are stable, said Singh.
She added that in the private sector people get Vitality points for having mammograms after the age of 40, so the medical scheme is bound to detect more cases.
Discovery said the number of people screening for breast cancer with mammograms has increased 26% since 2011.
Those found with a more deadly cancer that has spread are less likely to have been screened. Metastatic breast cancer increased from 12% of patients to 19% between 2011 and 2017.
Among Discovery members, prostate cancer is the most common among men, while breast cancer is the most common among women. The average age that people get breast cancer is 57.
The second-most common cancer in men and women is colon cancer.
The risk factors for colon cancer disease are poor diet, diets high in red meat, obesity and a lack of exercise.
Discovery Medical Scheme said colon cancer is also one of the costliest cancers to treat since new medicines cost between R181,865 and R106,656 per patient.
It found, cancer is highest among its members aged between 76 and 80.
A separate report on Discovery cancer care stated: “The total cost paid by the scheme for oncology-related treatment has increased by 103% from 2011 to 2017, with a total of R3bn [spent] in 2017. The increase is made up of a combination of factors, including an increased prevalence of cancer and partly due to the introduction of new high-cost treatments.”
Medical aids are designed in law as a stokvel, with funds shared among members for people at their sickest.
This means growing costs to treat cancer due to new drugs and new technologies mean higher premiums for every person or less money left over for other members.
What is driving costs is new robotic surgery used in prostate cancer that is less likely to damage the prostate gland and cause sexual problems. This surgery is 174% more expensive than older styles of surgery, said Discovery.
The average cost of medication for a breast cancer patient is R39,000, said a Discovery release, but those with a specific type of breast cancer (HER2 positive) need a year’s course of Herceptin. This new medicine costs between R355,000 and R500,000 per person, depending on their weight.
• On the day Discovery released its claim statistics, the World Health Organisation released a study of the activity levels of 1.9 million people in 168 countries.
It found that even though it is known that exercise reduces the likelihood of contracting colon and breast cancer, almost a third of people worldwide don’t exercise enough.
Adequate exercise is considered to be 150 minutes a week of moderate exercise, such as a brisk walk, or 75 minutes of very high-intensity exercise, such as running.
The study said “the health benefits of physical activity are well established and include a lower risk of cardiovascular disease, hypertension, diabetes, and breast and colon cancer”.