You have cancer – three words no one ever wants to hear but especially those individuals under the age of 50. Sadly, the incidence of early-onset cancer, those diagnosed between the ages of 18‑49, is increasing in the U.S. and globally. As this age range is the largest band being insured and with the financial and medical implications a cancer diagnosis can create, it is a trend worth highlighting in May which is Disability Insurance Awareness Month.
According to the “Cancer Statistics 2024” report from the American Cancer Society, while cancer deaths are falling, new cases are increasing.1 Younger adults are the only age group with an increase in overall cancer incidence between 1995 and 2020 – a rise of 1% to 2% each year during that time period, with colorectal and breast cancer being two of the most prominent diagnoses at younger ages.
The cause of early-onset cancers has not yet been determined, but some scientists believe it’s related to lifestyle, dietary and environmental factors, obesity, and antibiotic exposure. A new study presented at the annual meeting for the American Association for Cancer Research suggests the rise of cancer at younger ages might also be the result of faster biological aging, which happens as cells and tissues accumulate damage in the under‑50s.2 Biological aging is accelerated when a person’s biological age is higher than their chronological age. The results of the study indicate that “participants born in or after 1965 had a 17% increased likelihood of accelerated aging compared to those born between 1950 and 1954”.
With the concern for early-onset cancers, screening tests have been recommended at lower ages. In May 2021, colorectal guidelines changed from routine screening starting at age 50 to age 45,3 and in May 2023 breast cancer screening was lowered from age 50 to age 40.4 However, for either type, it is possible screening may be done at even younger ages depending on clinical risk factors.
Underwriting Perspective
From an underwriting perspective, it’s important to understand the new screening ages and the importance of having recommended screenings completed prior to underwriting decisions, especially where there are associated symptoms or a family history of concern.
Cases with subjective symptoms and no diagnosis, or where recommendations exist for additional testing, should be evaluated carefully. Underwriters should consider holding off on decisions until recommended testing and work‑up is completed.
As previously mentioned, May is Disability Insurance Awareness Month, and we think that higher rates of cancer at younger ages underline the importance of disability insurance cover. Not only does a cancer diagnosis have implications for one’s wellbeing, but it can also have a significant impact on personal finances and the ability to work long-term. If insurers are to continue offering the best disability insurance protection, it’s important to be aware of concerning trends and respond accordingly to mitigate the changing risks.
Don’t hesitate to contact us if you want to know more about the different underwriting risks around early-onset cancer or other trends affecting the Disability insurance underwriting environment.
Endnotes
- Siegel, Giaquinto, Jemal, “Cancer Statistics,” February 16, 2024, American Cancer Society Journals, https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21820
- “Early-onset cancer: Faster biological aging may be driving rates in young adults,” MedicalNewsToday, https://www.medicalnewstoday.com/articles/faster-aging-linked-to-early-onset-cancer#Faster-aging-linked-to-early-onset-cancer-risk
- Colorectal Cancer: Screening, Practice Considerations, May 18, 2021, U.S. Preventive Services Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening#bootstrap-panel--6
- “What to Know About New Breast Cancer Screening Recommendations,” Breast Cancer Research, https://www.bcrf.org/blog/uspstf-new-breast-cancer-screening-guidelines-2023