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Beyond Movember
November  2021

Decreased cancer screening due to COVID-19 impacts cancer mortality

Apart from Thanksgiving, Veteran’s Day, beautiful fall foliage and changing clocks, November is known as Men’s Health Awareness Month or Movember. This global annual charity event that encourages men to grow mustaches was created by the Movember Foundation in 2003 to raise funds and awareness for men’s health issues, with a particular focus on prostate cancer, testicular cancer and mental health. Concerns about those medical conditions have been rising in recent years, and the pandemic has negatively impacted and added uncertainty about the future of men’s health. 

Prostate cancer
Movember’s initial focus, affects one in eight men during their lifetimes, particularly at older ages. Although it is the second leading cause of cancer death in American men according to 2021 data from the American Cancer Society, its slower progression poses a unique challenge on disease management – maintaining the quality of life instead of avoiding mortality. SCOR’s 2020 article discusses knowledge and strategies both patients and insurance providers need to consider in managing this cancer.  

At SCOR, we have made important updates on prostate cancer earlier this year in our  SOLEM Americas Underwriting Manual to reflect the most up-to-date knowledge about this disease. “The SOLEM Americas’ information page on prostate cancer was improved to include the most current facts and relevant details, while the ratings page was overhauled to give guidance using the most recent data and statistics regarding its treatment and mortality risk,” says Dr. Regina Rosace, SCOR’s Vice President and Medical Director who oversaw and directed those updates.

Rachel Swigert, Senior Underwriter and SOLEM manual lead comments, “Two colorful charts in our on prostate cancer section in SOLEM, broken down by radical prostatectomy and radiation therapy, are designed with the underwriter in mind, to easily identify the appropriate mortality rate. This revision is easy to decipher and playful to the eyes. I believe it will be a welcome change for our clients.” 

Testicular cancer
Although it is lesser known than prostate cancer, testicular cancer is the most common solid malignancy affecting young males (aged 15 to 35). The many risk factors for this cancer, include cryptorchidism, hypospadias, contralateral testicular cancer, family history, HIV infection, genetic disorders and even marijuana use, according to recent studies1,2,3,4,5,6,7,8

Our SOLEM manual has a section for testicular cancer, and we are currently reviewing it for pertinent revisions and potential updates using the most recent staging, treatment and prognosis information.

Mental health
Concerns over men’s mental health, the third pillar of Men’s Health Awareness Month, are also rising. A recent CDC study found worsening anxiety and depression during the pandemic. Suicide rates are rising among younger ages (10 to 34 years old), along with certain minority groups including Black, American Indian, Alaska Native, and Hispanic males, according to a new report from the U.S. Centers for Disease Control and Prevention.

Recent investment by SCOR Life & Health Venture in ifeel, a mental health solution platform provider in Spain, is one of SCOR’s proactive commitments globally addressing mental health issues through innovation and partnerships. 

Lung cancer
In addition to Men’s Health Awareness Month, November is also Lung Cancer Awareness Month. Cancer is the second major cause of death, and lung cancer is the leading cause of cancer death, according to Center for Disease Control (CDC). Yet, it is a disturbing fact that lung cancer has a significantly lower screening rate compared to other cancers such as breast, colon and even prostate cancers. Seven of eight adults who met screening criteria for lung cancer did not report recommended screening, according to the 2017 survey.

Screening rates for breast cancer (67%), colon cancer (69%) and prostate cancer (39%), on the other hand, are higher. Those numbers, however, were in the pre-COVID period. The pandemic has caused temporary but dramatic decreases in cancer screenings and cancer diagnostics, which is raising concerns as some early cancers may have gone undetected, resulting in missed early treatment opportunities and potentially serious consequences. 

This pandemic has brought another negative side effect to people’s health. Smoking, one of the major causes of lung cancer, is seeing a surprising comeback. Cigarette sales have increased during the COVID-19 pandemic, and the number of people seeking help to quit smoking decreased, driven by quarantines, anxiety and depression.    

While it is still premature to determine the exact scale of impact, the effect of COVID-19 pandemic on cancer mortality may be substantial. Delayed diagnoses, decreased rates of preventive care, increased unhealthy lifestyles among some people and interruptions or cancellations of treatment likely will lead to increased mortality due to cancer in years to come. The National Cancer Institute has estimated a 1% increase in deaths from breast and colorectal cancer over the next 10 years, the equivalent of approximately 10,000 excess deaths due to the pandemic’s impact on screening and treatment. 

Early detection, healthy lifestyles, medical advancements and public awareness are all important for cancer prevention and cure. SCOR is committed to be a part of this grand quest through various contributions including underwriting, mortality research, health and wellness partnerships, innovation and risk management. 

1 Cooper, Christopher S, MD, Docimo, Steven, MD. Undescended testes (cryptorchidism) in children: Management
2 Yang, Xming J., MD, Richie, Jerome P., MD. Testicular germ cell neoplasia in situ
3 Kantoff, Philip, MD. Extragonadal germ cell tumors involving the mediastinum and retroperitoneum
4 Snyder, Peter, MD. Causes of primary hypogonadism in males
5 Chung, Daniel C, MD. Peutz-Jeghers syndrome: Clinical manifestations, diagnosis, and management
6 Braunstein, Glenn D, MD and Anawalt, Bradley D, MD.  Epidemiology, pathophysiology, and causes of gynecomastia
7 Taplin, Mary-Ellen, MD. Testicular sex cord stromal tumors
8 Lacroix, Andre, MD. Cushing's syndrome due to primary bilateral macronodular adrenal hyperplasia