- A pivotal role to play. Employers can help reverse the trend of rising early-onset cancer rates by expanding screenings to younger generations of employees.
- The benefits of early screenings. Implementing early screenings can have significant benefits for both individuals and organizations in terms of health outcomes and cost savings.
- Lower screening rates advised. The U.S. Preventive Services Task Force lowered the age of recommended first screenings for colon cancer to 45, and there is a 2023 draft recommendation to lower the age of first screening for breast cancer to 40.
- Benefits to both parties. Encouraging screenings at younger ages increases the likelihood of detecting health issues in their early stages, as this can result in substantial cost savings for both individuals and organizations.
As new research shows that younger people are increasingly being diagnosed with certain types of cancer, health experts say the push to include screenings at younger ages in employers’ healthcare offerings can have multiple benefits.
In a study published in JAMA Network Open, researchers discovered that cancers among people younger than 50 have increased slightly overall, with the largest increases among those ages 30 to 39, despite a decline in older populations.
The researchers analyzed data from more than 560,000 patients in the United States diagnosed between 2010 and 2019 with early-onset cancer — defined as cancers that affected people younger than 50, according to the Washington Post.
Overall, early-onset cancer diagnoses rose by nearly 1% during the study period to 56,468 patients, up from 56,051 patients in 2010. The trend was most pronounced in the 30-to-39 age group, with cases increasing about 19%.
There were also significant increases in certain types of cancer, with breast cancer accounting for the highest number of cancer cases in younger people, and increased about 8% over the 10-year period. Gastrointestinal cancers, including of the colon, appendix and bile duct, increased about 15% during that time.
‘Room for Improvement’
Employers may have a role to play in helping to reverse the troubling trend.
“Total rewards professionals should consider health plans that encourage and cover screenings at younger ages,” said Dan Schwabel, managing partner of Workplace Intelligence. “Implementing proactive health measures, such as early screenings, can have significant benefits for both individuals and organizations in terms of health outcomes, cost savings, and overall well-being.”
Encouraging screenings at younger ages increases the likelihood of detecting health issues in their early stages, he said, adding that catching health issues early can result in substantial cost savings for both individuals and organizations.
Currently, the Affordable Care Act requires that employer-sponsored health insurance plans cover (with no cost sharing) evidence-based screening for cancer, which includes breast, colorectal and cervical cancer screening in broad populations, and lung cancer screening in some smokers and former smokers, said Jeff Levin-Scherz, population health leader, health and benefits at WTW.
The U.S. Preventive Services Task Force lowered the age of recommended first screenings for colon cancer to 45 in 2021, and a 2023 draft recommendation would lower the age of first screening for breast cancer from 50 to 40, he said.
“Even though this draft has not yet been finalized, in my experience, most employers already cover screening mammography from age 40 without cost sharing,” Levin-Scherz said, “so most women will not have to wait for these guidelines to be finalized to gain access to these screening tests without cost sharing.”
And while the rates of breast, colon and cervical cancer screening are relatively high, Levin-Scherz said, rates of lung cancer screening are under 25%, so there is “plenty of room” for improvement.
“Even though the incidence of serious cancers in younger adults is going up, the incidence of cancer in those over 50 is much higher,” he said, “so the number of screening tests needed to diagnose an early cancer is much higher in younger patients.”
Preventive Medicine
The demand for earlier screenings is growing on a generational level, according to new research.
For example, Mercer Marsh Benefit’s “2023 Health on Demand” found preventative cancer screenings were ranked as the No. 3 most valuable part of a healthcare plan for Gen Z and No. 1 for all working generations. Cancer screening also leads the list of benefits that many other groups would find helpful, including remote workers, caregivers and people with below-median earnings.
Preventive cancer screenings were also selected as the No. 1 interventions that caregivers find helpful, for unwell employees, and for bottom-band household income earners, according to the study.
As evidence that employers may not fully appreciate the value employees place on screenings, Mercer Marsh also found that preventive cancer screenings show the biggest gap between the reproductive benefits employers provide (28%) and those employees find helpful (50%).
So, how can employers close that gap?
When it comes to benefits design, employers can err by crafting a plan around an “average” patient, said Mary Kay O’Neill, senior health consultant at MercerWELL.
“Not everyone is an ‘average’ patient,” she said.
“If somebody has a positive family history of early-onset breast cancer, it’s not appropriate to wait for the standard screening time frame,” she said. “What’s appropriate is to do what’s most appropriate for the individual’s risk.”
But if an organization’s coverage policy does not include coverage for early screenings, then at-risk younger workers won’t get the same benefit as older ones because they may have to pay co-insurance and/or a hefty co-pay in order to get screened, O’Neill said, adding that it may also discourage them from getting screened at all.
“You want to have them do those tests,” O’Neill said, “because those are probably the people for whom it is most important and most valuable.”
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