Cancer cases are skewing younger: How one insurer is responding

By Susan Rupe

Cancer diagnosed in adults between the ages of 18 and 49 – also known as "early-onset cancer" – has been on the rise recently and that increase has prompted one voluntary benefits carrier to examine the way it responds to this trend.

The American Cancer Society’s Cancer Statistics 2024 report revealed that although cancer deaths are falling, new cases are ticking upwards — from 1.9 million in 2022 to over 2 million in 2024 – that’s almost 5,500 cancer diagnoses a day.

More of those new cases involve younger people. The ACS report showed younger adults to be the only age group with an increase in overall cancer incidence between 1995 and 2020 — the rate has risen by 1% to 2% each year during that time.

The rise in diagnoses is largely affected by the aging and growth of the population and by a rise in diagnoses of six of the 10 most common cancers—breast, prostate, endometrial, pancreatic, kidney and melanoma. The other four top 10 cancers are lung, colon and rectum, bladder, and non-Hodgkin lymphoma.

In 2024, more than 611,000 deaths from cancer are projected for the U.S. That’s more than 1,600 deaths each day.

Cancer death rates down, but diagnoses on the rise

Although the cancer death rate has been on the decline, the ACS said rising diagnoses of six of the most common cancers (breast, prostate, endometrial, pancreatic, kidney and melanoma) threaten that longstanding downward trend. Put simply, that’s because when more people are diagnosed with cancer, more people are likely to die because of it.

Some types aren’t increasing in overall incidence but are increasing in subgroups. These include:

Colorectal cancer in people younger than age 55.
Liver cancer in women.
Oral cancers associated with HPV.
Cervical cancer in women ages 30 through 44.

People age 65 and older represent a growing proportion of the overall population, but their numbers are shrinking in the proportion of new cases. In 1995, people aged 65 and older accounted for 61% of cancer diagnoses and during 2019 to 2020 that percentage dropped to 58%.

In contrast, people ages 50 to 64 are growing in numbers for both the population at large and the population of people with cancer. This shift toward middle-aged patients reflects both steep decreases in the incidence of prostate cancer and smoking-related cancers in older men and increasing incidence in men and women born since the 1950s. Although some of this increase is probably because of the obesity epidemic, there are thought to be other unknown causes as well.

The proportion of people under age 50 diagnosed with cancer dropped from 15% to 12% because of their shrinking representation in the general population (from 74% to 64%). However, they were the only one of the three age groups with an increase in overall cancer incidence from 1995 to 2020.

Especially notable is the rise in colorectal cancer diagnoses among people younger than 50. In the late 1990s, colorectal cancer was the fourth leading cause of cancer death in both men and women in this age group, and now, it is the first cause of cancer death in men younger than 50 and the second cause in women that age. The cause of the rise of colorectal cancer cases in younger adults remains unexplained but likely reflects changes in lifestyle exposures that begin with generations born around 1950, the ACS said.

Almost 1 out of 3 people diagnosed with colorectal cancer before age 50 have a family history or genetic predisposition. People who know they have a family history of this disease should begin colorectal cancer screening before age 45.

An insurer’s perspective

Keith Farley is Aflac’s senior vice president of individual voluntary benefits. He leads the team that sells cancer insurance at Aflac. He spoke with InsuranceNewsNet about the uptick in cancer diagnoses among younger adults and Aflac’s perspective on the trend.

“We are looking at how we serve that market of younger people,” he said. “It starts with how we present our brand through marketing. Where are we marketing? How are we marketing to our distribution? How are we reaching younger people?”

To reach younger adults, Aflac is increasing its marketing on social media and making its mobile apps more accessible to this demographic, Farley said.

“From a distribution standpoint, it’s making sure we have the right products with the right benefits. If people want to buy it through the workplace – which is where people traditionally buy it – we want to have that option. But if people want to buy it online, we want to be able to give them that digital experience.”

The claims process also is important, Farley said, with Aflac creating what he called “an entire cancer ecosystem around claims where you do the entire claims process start to finish online or you can go to the call center and talk to someone if you prefer that option.”

Despite the rise in cancer among young adults, there is a reason to be optimistic, Farley said. “The good news is that, in many cases, it's being detected earlier, through things such as wellness screenings,” he said.

Aflac policies include a wellness benefit, where the carrier pays policyholders if they schedule a wellness visit with their doctor.

“A great amount of cancer cases are detected through these visits,” he said. “And the great news is that the survival rate has gone up significantly, thanks to advances in treatment as well as early detection. We’re seeing all this in our claims.”

Aflac’s claims show an increase in colorectal cancer, melanoma, breast cancer and prostate cancer in adults under the age of 50, Farley said.

“But you also see an increase in the five-year survival rate,” he said. “According to the American Cancer Society, the five-year survival rate went from 49% in the mid-1970s to 69% in 2019. So what we look at from a claims perspective is, the survivability rate is up and that’s a wonderful thing”

Aflac has a section of its call center devoted to helping policyholders who have been diagnosed with cancer for the first time.

“In the world of the digital apps where you can have a completely seamless experience with no humans involved, the cancer line that we have in our call center makes us recognize that sometimes when you've been diagnosed with a disease like cancer, you just want to talk to a human,” Farley said. “You don’t want artificial intelligence to help you make the decisions you’re faced with. We mustn't forget that the first word in artificial intelligence is ‘artificial.’ Sometimes you want something authentic, like talking with a human. So we make sure that we have that authentic experience for those diagnosed with cancer.”

Although in many cases, cancer is becoming more of a survivable disease, that doesn’t mean a patient’s financial problems end when that patient rings the bell to celebrate the end of treatment. Farley said Aflac has a survivorship benefit, which helps policyholders cover cancer-related expenses that arise post-treatment.

“There’s life after cancer,” he said. “We want to make sure that you have your finances in order to continue that life, because there will be new expenses that you have after you beat the disease. And we want to make sure that it doesn't knock you off from your financial goals and your hopes and dreams beyond the cancer.”

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on X @INNsusan.