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Global reinsurer, Hannover Re, has released an informative article on 7 Aug 2018 on the topic of Thyroid Cancer (New trends in thyroid cancer – a true incidence rise or over-diagnosis ?).  The document can be found here. It discusses the reasons for the dramatic incidence rise of thyroid cancer in the last three decades and possible implications for life insurers.  Thyroid cancer may (depending on your policy and its wordings) be a covered condition in a life insurance policy that offers trauma insurance.

Some extracts from the document are :

1. Thyroid cancer (TC) is the most prevalent endocrine cancer, accounting for about 95% of all such malignancies. The incidence of this cancer has increased dramatically in the last three decadesExposure to ionising radiation is the most established direct cause of thyroid cancer, and it was the first solid tumour type noted in Japanese atomic bomb survivors
2. The thyroid is particularly sensitive to irradiation because it concentrates radioactive fallout iodine as it creates thyroid hormones.
3. Many tools used in medicine also require radiation exposure, notably x-rays and CT scans
4. Consequently, in many health jurisdictions thyroid shielding is required when undergoing ‘routine’ but required radiological investigations
5. Diet may play a role in two ways
6. Genetic factors also increase the risk for developing thyroid tumours. About 6% of malignant papillary tumours are familial and up to 30% of medullary cancers have a hereditary component
7. Other environmental factors, especially chemicals, could explain a rise in mutations – most notably nitrate contamination of drinking water and the use of pesticide
8. Globally, TC is the 16th most common cancer diagnosed, with 298,000 cases diagnosed in 2012; female lives constitute 70–75% of the diagnoses
9. Over two-thirds of adults will be found to have nodules in their thyroid when undergoing an ultrasound scan (almost all of them are benign)
10. Therefore, it is perhaps unsurprising that when South Korea introduced a programme in 1999 under which patients could elect to purchase such a service incidence rates of thyroid cancer exploded, with the result that by 2011 the thyroid cancer diagnosis rate was 15 times the rate seen at the beginning of the programme.
11. An estimated 50–90% of thyroid cancer (particularly in women) being the result of over-diagnosis.
12. If the over-diagnosis hypothesis was the only cause of the incidence rise, we should see rates increasing solely in the lower and less aggressive types.
13. Yet the incidence has increased for all types by 3% annually in the last 30 years, with mortality increasing by 1.1% per year for all types and by 2.9% p.a. for advanced-stage papillary in the same period
14. In the US, the 5-year survival rate for thyroid cancer overall is 98.1%
15. This rise in incidence in the population is being reflected in claims in certain markets, particularly for products like critical illness (trauma insurance). In the UK, for example, it is the sixth most common cause of female cancer claims.