In the fight against cancer, we’ve come a long way with screening and advances in treatment. Survival rates are up for many cancers, and the chances of making a recovery are better than ever.
Now is the time to turn our attention to prevention and focus on modifiable risk factors, such as smoking, diet and physical inactivity, which contribute to 40–45% of the global 10 million annual cancer deaths.
Smoking reduction has already shown how public health campaigns can have a meaningful impact on reducing cancer.
In the UK, sustained reductions in smoking prevalence have been followed by declines in lung cancer incidence and mortality.
This change was driven by education, a ban on smoking in public places, pricing signals, and visually reinforced by graphic warnings.
For insurers, this evolved into the widespread adoption of smoker and non-smoker pricing. Behaviour changed, and outcomes followed.
Other public health campaigns have been effective in driving behavioural change.
Australia’s “Slip, Slop, Slap” campaign, encouraging people to cover up and use sunscreen, targeted the risks for skin cancer.
Over time, melanoma death rates in younger age groups fell dramatically.
Focus on risk assessment
Despite these examples, prevention still plays a limited role in how the insurance industry assesses cancer risk.
Understandably, much of the focus is on risk assessment and on keeping pace with advances in diagnostics and treatment.
This seems logical, given that insurers must manage applicant and policyholders who have, or have had, cancer.
Yet cancer remains the leading cause of claims across life insurance products, underscoring that prevention is as much a commercial issue as underwriting and claims.
A promising area for our industry to strengthen prevention efforts is around metabolic health.
Metabolic ill-health, especially insulin resistance and visceral fat, can create a pro-cancer internal environment, with high insulin, other hormonal dysregulation and chronic inflammation playing a key role.
The World Health Organization currently recognises 13 obesity-related cancers.
Emerging evidence suggests associations with up to 32 cancer types. If this is confirmed, excess body weight could account for up to 40% of cancers.
In the UK, where nearly two-thirds of adults are overweight or obese, this is not a marginal issue. Rather it is a systemic one with long-term implications for cancer incidence, claims severity and portfolio sustainability.
‘Medication alone is not a prevention strategy’
The rapid rise of GLP-1 weight-loss medications has pushed metabolic health into the mainstream consciousness.
Originally developed for diabetes, these drugs have demonstrated substantial improvements in weight loss and insulin resistance.
Swiss Re modelling suggests that, under optimistic assumptions, widespread and sustained improvements in metabolic health could reduce all-cause mortality in the UK by more than 5% over the next two decades, with clear implications for future cancer risk.
Medication alone, however, is not a prevention strategy. Without sustained lifestyle and nutritional change, discontinuation and weight regain are common.
This is where insurers can add value.
Insurer-led programmes promoting physical activity, fitness and healthier lifestyles already demonstrate that insurers can engage customers beyond claims and underwriting, and that consumers are willing to participate.
Encouragingly, insurers start from a position of trust. Customers already share health information and maintain long-term relationships with insurers.
That trust, combined with data and incentives, creates a powerful platform to support sustained behaviour change in ways that are difficult for healthcare systems or employers to replicate alone.
Significant disability insurance benefits
A recent UK disability insurance pilot illustrates what this can look like in practice.
The pilot targeted claimants whose long-term absence from work was strongly influenced by metabolic dysfunction.
Participants achieved sustained weight loss, improvements in insulin resistance and reductions in medication use.
Importantly, a meaningful proportion of claimants returned to work.
The financial return was significant, and the human benefit was evident; approximately £790,000 in claims reserves were released at a programme cost of approximately £32,000. Notably, no weight loss medications were used in the pilot.
World Cancer Day is a timely moment to reframe the role of prevention in insurance.
With a large proportion of cancer risk linked to modifiable risk factors, and metabolic health central to that risk, prevention increasingly represents long-term risk management rather than discretionary spend.
The evidence is compelling, the tools are emerging, and insurers already have the trust needed to drive change.
