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Almost one in four cases of female breast cancer diagnoses around the world are in the Asia-Pacific region – the highest proportion of new cases in China (46%), Japan (14%) and Indonesia (12%). The global total of new cancer cases is projected to rise by 70% over the next two decades.1
The distribution of breast cancer around the world is changing, with Asia forecast to get more cases. Whereas the incidence of breast cancer in Asia is lower than in North America, Western Europe and Oceania, rates in Asia have been increasing rapidly. This trend is due to people living longer (as mortality from communicable disease falls), decline in breastfeeding and its duration, the fall in age at menarche, the increase in fat consumption, the westernization of lifestyle and diet in parallel with a potential decline in the consumption of traditional foods.
Screening for breast cancer, which may improve early detection and outcomes, plays a role in rising figures, too. South Korea, Japan, Singapore, China and Taiwan have initiated population-based breast cancer screening programs. However, the effectiveness of mammography for screening among Asian women is unproven and must be adapted prudently, with appropriate customization for each region.
Despite screening programs in some countries, there is misunderstanding in parts of the Asia-Pacific region about how breast cancer develops and can be treated, in addition to a lack of awareness about the risks and a reliance on traditional remedies. Geographical isolation, inadequate diagnostic equipment and treatment facilities, and competing healthcare needs represent significant economic obstacles to cancer prevention and control.
Unsurprisingly, there are significant differences in mortality trends between Asia and the West. Survival Rates and Mortality-to-Incidence Ratio (MI Ratio) for countries with developed healthcare systems in Asia are comparable to the West, while emerging markets are lagging behind. In Japan incidence rates increased on average 6% per year between 1999 and 2008.2 Incidence rates rose by 3% to 4% per year in China, Singapore and Thailand over the same time period. Soon the majority of breast cancer patients worldwide will come from Asia.3
While the numbers may not be encouraging, the gains made in breast cancer treatment in recent decades are likely to continue. Tailored therapies for individual patients through molecular profiling and targeted therapies could improve breast cancer survival rates in Asia in the future.
For insurers, increases in screening uptake and more advanced technology will increase the diagnosis of early breast cancer and carcinoma-in-situ. This will be reflected in both underwriting and claims for Critical Illness and cancer products and have a significant impact on product development, pricing, underwriting and claims, particularly around these products in Asia.
