Who is at higher risk of cancer and how can life insurers help?

Cancer often strikes in what appears to be a random fashion; however, this is not always the case. Maybe it’s a relatively young person with no apparent risk factors. They eat right and exercise regularly. Yet despite this person’s age and healthy lifestyle choices, he or she is still diagnosed with cancer. It’s easy to look at a situation such as this and assume that risk factors are meaningless. Yet nothing could be further from the truth.

Today there are several known cancer risk factors, from advancing age to an individual’s own personal health care and lifestyle choices. This means some policyholders have a greater risk of developing cancer than others. In this article, we take a closer look at cancer risk factors to identify which policyholders are at greater risk. From there, we’ll introduce Galleri®, a multi-cancer early detection (MCED) test from GRAIL, LLC (“GRAIL”), describing how it creates an opportunity to improve mortality by bringing this revolutionary test to the life insurance industry.

While there are a number of factors that influence one’s risk of developing cancer, advancing age is definitely the most common one. As a person ages, the risk of a cancer diagnosis increases significantly. In fact, an individual over the age of 50 is 13 times more likely to develop cancer than someone below that age. As pictured in the graph below, the incidence rates for cancer overall climb exponentially as age increases, from fewer than 25 cases per 100,000 people in age groups under age 20, to about 350 per 100,000 people among those aged 45 to 49, to more than 1,000 per 100,000 people in age groups 60 years and older. The basis for this rising incidence lies with the regular division of the roughly 100 million cells in the human body, a fundamental process for life. Genomic damage may happen randomly during this cell division, and this process becomes less efficient as we age—increasing the likelihood that the damage can lead to cancer. In addition, the accumulation of external risks, such as smoking, alcohol, or sun exposure, can also accelerate the damage process.

An individual over the age of 50 is 13 times more likely to develop cancer than someone below that age.

Despite the undisputed relationship between advancing age and increased cancer risk, there are other factors that increase the risk of cancer even more, smoking being one of them. Individuals who currently smoke and former smokers who quit within the past 30 years are at a high risk of developing cancer, particularly lung cancer, which is the most common cause of cancer death in the United States. But smoking also increases the risk of a number of other malignancies, including mouth, throat, esophageal, kidney, bladder, pancreas, stomach and colorectal cancers. Even second-hand smoke can increase one’s cancer risk.

Body mass index (BMI) is another important risk factor. BMI is a measure of body fat based on height and weight. Females with a BMI greater than or equal to 30 and males with a BMI greater than or equal to 35 have a higher risk of developing cancer. According to research from the American Cancer Society, excess body weight is thought to be responsible for about 7% of all cancer deaths in the United States. Along the same lines as BMI, poor nutrition, heavy drinking, and a sedentary lifestyle are additional cancer risks.

Personal or family history of cancer is another important cancer risk factor. In terms of personal history, survivors of cancer are unfortunately not shielded from cancer forever, despite beating it once. While there is always a risk that the cancer will reoccur, survivors of cancer also have a greater risk of developing additional cancers in their lifetime. Individuals with first-degree relatives or multiple family members who have been diagnosed with cancer are more likely to develop cancer themselves. Indeed, some cancers are hereditary, meaning that a genetic mutation is passed on to future generations. Several hereditary conditions can raise the risk of developing cancer, and some significantly so. It is estimated that upto 10% of diagnosed cancers are associated with an inherited cancer gene.¹ However, this is much less common than the other risk factors previously mentioned, such as advancing age, smoking, and being overweight.

It’s now possible to analyze the percentage of invasive cancer incidences by aggregating the four cancer risk factors: advancing age, smoking, high BMI, and history of cancer. As shown in the graph below, male smokers with a high BMI and a first-degree family history of cancer have the highest invasive cancer incidence rate (about 25% at the age of 80), followed by female smokers with corresponding risk factors (about 15%). Note the significant difference between men and women as age increases. The risk of developing cancer in prime cancer years (age 50+) is significantly higher for men than women, especially for smokers. 

Male smokers above the age of 50 with a high BMI and family history of cancer have the highest invasive cancer incidence rate.

Individuals have control over some cancer risk factors—but not all of them. They can refrain from or stop smoking and maintain a healthy weight through regular exercise and a proper diet.^2,3 However, advancing age, which is the most important risk factor, cannot be controlled. This is why it is critical to use modern technology with cancer screenings and early detection tools. 

For starters, individuals can commit to regular health checkups and FDA-recommended cancer screenings such as a mammogram and colonoscopy. Individuals are encouraged to engage their health care providers and start cancer screening as soon as it is appropriate.

Early detection of cancer through screening has been shown to reduce mortality from cancers of the breast, colon, cervix, prostate, and lung. For example, among those meeting screening criteria and undergoing the testing, deaths rates from breast and colorectal cancer decreased by 20-30%.^5,6,7 For cervical cancer, the mortality reduction was approximately 50% with screening.⁸ While these traditional screenings are effective, they are typically limited to these five types of cancer. However, there are more than 100 other known types of cancer, and many of them go undiagnosed until it’s too late to prevent death. In fact, 71% of cancer deaths result from cancers with no recommended screening. What if there was a way to detect most of the other cancer types? 

71% of cancer deaths result from cancers with no recommended screening. 

Galleri® can detect more than 50 types of cancer, over 45 of which there is no recommended screening.

The Galleri^® test is an MCED test developed by GRAIL. With a single blood draw, Galleri^® can detect a shared cancer signal across more than 50 types of cancer. The vast majority of cancer types that can be detected by Galleri^®, of which there are more than 45, currently lack any recommended standard screening paradigms. The Galleri^® test can predict the cancer signal origin, or where the cancer is located in the body, with high accuracy to help guide the next steps to diagnosis. Early detection is key to catching cancers when treatment is more likely to be successful. High cancer risk policyholders—those aged 50 and older or between the ages of 35 and 50 with elevated risk factors—can take the Galleri^® test on an annual basis to significantly increase their chances of detecting more types of cancer in early stages, when they can be cured. 

Cancer is the number one cause of death amongst life insurance policyholders over 50 years old, according to historical claim data from Munich Re Life US. But with early detection, survival rates can significantly improve, making it possible to bend the cancer mortality curve and reduce cancer death claims.

The Galleri^® test is a potential life-saver, and that’s an obvious incentive for insurers. The future mortality savings associated with reduced cancer mortality can be significant for life insurers. It can outweigh the cost of offering a one-time test, according to a cost-benefit analysis done by Munich Re Life US. The mortality savings can vary by age, gender, product type, and are greater for high cancer risk individuals. For example, the mortality savings for a policyholder who smokes is on average two times more than a non-smoker policyholder, due to the increased cancer risk associated with smoking. This demonstrates that mortality savings from using the Galleri® test can be significant for policyholders with an elevated risk of cancer.

While saving lives is the number one incentive for offering the Galleri® test to policyholders, there are additional benefits beyond the mortality savings for insurers, including new sales growth in competitive distribution channels, policyholder retention, and stronger brand positioning. To learn more about the benefits of integrating Galleri^® into your suite of policyholder benefits, read our article titled, Changing the Future of Cancer Mortality. 

Cancer is the #1 cause of death for the insured population over the age of 50.

Galleri® can lead to significant mortality savings for high-risk individuals.

We invite all life insurance industry pioneers to consider offering Galleri^® to their policyholders who meet the eligibility criteria. While existing health care procedure offers proactive cancer screening that will save lives, the Galleri^® test can help take cancer detection to an entirely new level. We believe policyholders will respond favorably to life insurers who offer this groundbreaking test.

Life insurance carriers, distributors, and reinsurers alike have a tremendous opportunity to be at the forefront of this effort to help save lives. We believe life insurance companies in the private sector can play a significant role in enabling access to life-changing technologies such as the Galleri^® multi-cancer early detection test. By shifting our role in the lives of policyholders and their families to promote health and longevity, we can change how we are perceived while improving the future of cancer mortality. Together, we can make a significant difference. We hope you’ll join us in the fight against cancer.  

Companies interested in learning more about Galleri® and about offering Galleri® to their policyholders should reach out to Munich Re Life US directly. Munich Re Life US and GRAIL have created a full suite of educational materials and processes to simplify program integration for you and your teams.