Cervical Cancer: Progress or Progression

Of the 200 different kinds of cancer, cervical cancer is relatively rare. In 2007, it is expected that there will be about 1,350 new cases, and 390 deaths in Canada. While the causes are not often known, it has been estimated that about half of all cancers could be prevented with better lifestyles – diet, exercise, quitting smoking, and limiting alcohol intake and exposure to the sun. Most cases of cervical cancer are diagnosed between ages 40 and 59.
The good news is that the rate of incidence (new cases) and death for most major cancers has stabilized or declined during the past decade. For cervical cancer, the number of deaths will be about half the rate in 2007 as thirty years ago, and the incidence of new cases is down 60% over this same period. This has been attributed mostly to greater awareness, more screening, and earlier detection.
Cervical cancer risk increases with sexual activity, particularly involving many partners and multiple pregnancies. About 80% of sexually active women will be infected with the Human Papilloma Virus (HPV). HPV types 16 and 18 cause about 70% of all cervical cancer; thirteen other strains account for the rest.
Many thousands of Canadian women will take a pap test and be diagnosed with precancerous cervical cell abnormalities (dysplasia) this year. Dysplasia may not cause any signs or symptoms in its early stages and it may develop into cancer if it isn't treated. The Canadian Cancer Society warns the new HPV vaccines should not replace screening because 30% of cervical cancer is not caused by the two main strains, and mid- and long-term efficacy of the new vaccines has not yet been clinically proved.
Cancer in the Workforce
It is estimated over 800,000 Canadians are cancer survivors. The working population, ages 20 to 59, account for about 30% (48,000 people) of all new cancer cases and 18% (13,000) of all cancer deaths. For at least the last twenty years, the incidence of cancer has increased in both men and women in their 20s, primarily non-Hodgkin lymphoma. Men in their 30s see a decline in incidence, while female rates continue to increase, mainly due to breast cancer. Cancer rates are stable during the 40s and then rise over the next decades of life for both genders.
Benefit Plan Pressures
One of the emerging issues in private drug plans is payment for oral cancer medications and cancer vaccines. Consider these facts:
  • Between 2006 and 2010, IMS Health forecasts there will be 50 new oncology products brought to market, with this class experiencing an 18% compound annual growth rate. While most oncology products are purchased by hospitals, 37% are purchased through pharmacies.
  • One pharmaceutical company has projected that 75% of 39 pipeline products (from all manufacturers), i.e., those likely to hit the market within the next seven years, will be oral medicines and therefore eligible under group benefit plans.
  • According to Manulife Financial, cancer ranks as the third most common type of LTD claim, and though ranked 11th in STD, cancer claims had the longest average duration at 138 days.
  • The Cancer Advocacy Coalition of Canada reported that four in ten (38%) did not return to work after cancer was in remission. Fatigue was the most important issue.
  • Many provinces mandate several weeks of compassionate care leave; 36% of cancer patients required others to take time from work.
Most cancers are age-related, so private plans have limited risk unless they cover retirees. Research emphasizes that employees (and future retirees) place very high value on benefits for financial security and emotional peace-of-mind. A combination of new therapies, high plan member expectations, social marketing, and media attention mean employers will play a continuing role in the direct and indirect cost of cancer.

Your Move
The best advice for employers is to stay informed, advocate for more public funding for cancer care, and consider human resources policy and practices related to access, fairness, support, and risk avoidance. Employers work hard to prevent injury and reimburse treatment costs for illness and injury. Most, however, do not pay for products and services that prevent illness, an important gap in both policy, program, and plan design.

  1. Canadian Cancer Society / National Cancer Institute: Canadian Cancer Statistics, 2007.
  2. IMS Health, with permission.
  3. Manulife Financial, with permission.
  4. Cancer Advocacy Coalition of Canada: Report Card on Cancer in Canada, 2006.
  5. Supportive Care in Cancer, 2006.


Categories: Disease Management