Cancer: Why screen, and what will it cost you?

The incidence of cancer in South Africa is expected to rise to 121,000 cases in 2030 – almost twice the 2019 figure of 62,000, according to a 2022 study published in the SA Journal of Oncology. The study makes clear that this non-communicable disease is a major – and growing – public health problem. 

National Cancer Registry data shows that one in four South Africans is affected by cancer, either directly or indirectly. We investigate why you should screen, and the costs involved.

Tip: Using a savings calculator can help you reach your financial goals.

Why are routine screenings recommended? 

Regular cancer screenings, and cancer treatments, dropped dramatically during the Covid-19 pandemic. Since that time, the long-term insurance industry has noticed a rise in cancer claims, says Corli Basson, business manager: underwriting at 1Life Insurance.

Leigh Solomon, head of underwriting and claims at MiWayLife, notes that early detection means early treatment and a greater chance of surviving a cancer diagnosis. 

“Fortunately, many people are now testing proactively, without being prompted by their doctors,” she says. 

Medical schemes generally provide guidelines on how regularly you should screen, but it's worth discussing with your doctor if you’re unsure.

What do medical schemes cover? 

Medical schemes cover routine screenings, with members reimbursed at medical aid rates, says Dr Noluthando Nematswerani, chief clinical officer at Discovery Health. 

These routine screenings typically include:

• Mammogram (X-ray of the breast) and breast ultrasound for women. This is recommended every two years if you are over 40 and your risk is average, while an annual mammogram and breast magnetic resonance imaging (MRI) scan is covered for higher-risk patients. If you have a family history of breast cancer, it’s advisable to see a genetic counsellor as soon as possible to obtain guidance on appropriate genetic testing, such as a BRCA gene-mutation test.
• Prostate-specific antigen (PSA) test to detect prostate cancer in men. Testing can be done from age 55, but if you’re high-risk you could start testing around age 40. Population-wide screening isn’t recommended, as false positives are not uncommon and can lead to stress and unnecessary tests.
  “You would need to weigh up the benefits with your doctor,” says Nematswerani. “Risk factors that may prompt you to screen include having a father or brother with prostate cancer, and your age.” 
• Pap smear and human papillomavirus (HPV) test for women. Check how frequently your medical aid will cover you for a HPV test and Pap smear. At Discovery, the frequency of HPV testing is every three years, and every year for a Pap smear if you’re at high risk. The HPV vaccine, which prevents sexually active individuals from contracting HPV, is also recommended. “However, the HPV vaccine is funded from a member’s day-to-day benefits,” says Nematswerani.
• Colorectal screening. Colorectal and colon cancer are among the top three cancers for both men and women in South Africa, so screening is recommended, says Solomon. This could be a non-invasive faecal occult blood test every two years, or a colonoscopy for high-risk patients – for example, those with inflammatory bowel disease or hereditary conditions that may predispose them to cancer. Colorectal cancer patients often experience no symptoms in the early stages of the disease.

Patients may also qualify for the following tests, depending on their medical plan and option cover:

• Skin cancer screening (mole mapping)
• Lung cancer screening (a low-dose computerised tomography [CT] scan) 

If you have medical aid, contact your scheme to check your cover before booking your screening(s).

What does cancer screening cost?

If you’re not a medical scheme member, but wish to pay cash for screening at a private healthcare provider, here’s an indication of the costs you can expect*:

*Pricing current as at January 2024.

How to manage your health proactively

Cancer treatment can be prohibitively expensive. The Independent Clinical Oncology Network estimates the figure to be anything between R10,000 and R1m per patient annually.

Treatment is covered under the medical schemes list of Prescribed Minimum Benefits, but to qualify you must have the right level of cover, which may include medical aid (though there may be limits and co-payments), gap cover, and dread disease or other insurance.

Life insurers look favourably at clients who manage their risk. “If you test positive for BRCA 1 or 2, you won’t necessarily be unable to take out a life policy, however, an exclusion may come into play,” says Solomon.

The bottom line? Speak to a financial adviser about your needs and what type of cover may work best for you.

“If you have a policy in place and times are tough, don’t cancel your cover – rather reduce it to an affordable amount, as having some cover is better than none,” Basson recommends.

Tip: A personal loan can tide you over in a medical emergency.