The future of cancer and insurance: a 20-year outlook

Swiss Re projects declining mortality rates across five major cancers in the US and UK over the next 20 years. Although near-term life insurance claims may fall, the number of people being diagnosed with cancer and surviving it could create new challenges for Life & Health insurers.

Swiss Re analysed how rates of cancer incidence (diagnoses) and mortality could change in the US and UK general populations over the next 20 years for: breast, colorectal, lung, pancreatic and prostate cancer. Together, these cancers account for about half of all cancer diagnoses and deaths in the general population, and represent different patterns in risk factors, detection, treatment and outcomes. 

Our projections point to continued declining mortality across all five cancers. In the US, the combined age-standardised mortality rate for the five cancers is projected to decrease by 19-38% by 2044, with a similar decline of 14-36% by 2043 in the UK. The age-standardised rates for the UK and the US are not directly comparable because different standard populations and country-specific age-standardisation approaches were used. 

For Life & Health insurers, however, falling mortality is only one part of the picture. Cancer risk increases with age, so ageing populations are expected to increase the overall number of cancer cases. Earlier detection and improving outcomes also mean more people are likely to survive after a cancer diagnosis. Together, these trends will affect life, critical illness, disability, long-term care and medical insurance in different ways. 

Cancer mortality has historically been declining in the US and UK. However, this overall trend masks substantial differences between cancer types, as our projections for the five cancers show. Their outlooks vary depending on risk factors, detection and treatment. 

Lung cancer could see the largest improvement. In the US, diagnoses are projected to fall by 20–40% over the next 20 years, while mortality could decline by 30–55%, depending on sex and scenario. Mortality is also projected to fall substantially in the UK. Much of the improvement reflects the long-term benefits of historical reductions in smoking, alongside advancements in earlier detection and treatment. 

Pancreatic cancer has a very different outlook. Mortality is projected to decline by 5–20%, while diagnoses could rise by as much as 35% in some scenarios. Without effective population screening, pancreatic cancer is often diagnosed at a late stage, with a worse prognosis. 

Breast, colorectal and prostate cancer sit between these two trajectories, with mortality projected to decline but diagnoses varying by cancer, country and scenario. 

Cancer remains a major lifetime risk: around 4 in 10 people in the US and UK will develop cancer during their lifetime. Risk also rises substantially with age. Most cancer diagnoses occur later in life, with rates rising sharply after age 50 and peaking between ages 80 and 89. As people live longer, more are likely to develop cancer. 

Around 44% of cancer deaths globally are attributable to modifiable risk factors, although their contribution varies considerably by cancer type. Metabolic health, lifestyle behaviours and environmental exposures all influence the risk of developing cancer. 

But cancer is also becoming more common at younger ages. Early-onset cancers – cancer diagnosed before age 50 – accounted for around 11% of male and 21% of female cancer cases globally in 2022. Colorectal cancer is an example where diagnoses and deaths are rising among younger adults.  

Advancements in screening, biomarkers and AI-enabled diagnostics could help identify some cancers earlier and more precisely. Increasingly personalised and targeted treatments could further improve survival. But progress will remain uneven: the impact of earlier detection depends on the cancer, its biology and the availability of effective treatment. 

As cancer mortality improves, more people are living longer after a cancer diagnosis. This also means more people are exposed to recurrence, developing a new cancer, and the long-term effects of disease and treatment. 

These risks can persist long after the initial diagnosis. Cancer survivors are also more likely than the general population to develop a second cancer, although the risk varies. 

What this means for insurers will vary by type of insurance: 

• Life insurance: falling cancer mortality could mean fewer claims or claims occurring later in life. 
• Critical illness: more cancer diagnoses and earlier detection could increase or bring forward claims. 
• Disability insurance:  better treatment and rehabilitation can help people recover and return to work, although some may experience lasting effects that affect their ability to work. 
• Long-term care: longer survival could increase long-term care needs and exposure to other health conditions later in life. 
• Medical insurance: more cancer diagnoses could mean more people needing diagnosis and treatment. Ongoing monitoring, personalised treatments and longer-term care after cancer may also increase costs over a patient's lifetime. 

For Life & Health insurers, understanding how cancer incidence, mortality and survivorship develop will be increasingly important for underwriting, pricing, claims and product design.