Essential cancer screening and diagnosis services must be included in UHC schemes to reduce mortality

The earlier a cancer is detected, the easier it is to treat successfully, often with fewer side effects, and at a lower cost. In many high-income regions, such as Europe and the United States, survival rates for cancer have risen in past decades, in part thanks to routine screening that detects cancers at an early stage. It's especially true for common cancers like cervical, breast, colorectal, and prostate, where routine screening offers a clear test and methodology for early detection.

Investing in routine screening programmes for asymptomatic cancers as well as the early detection of symptomatic cancers and diagnostic and referral services is, therefore, a cost-efficient approach to mitigate the public health costs of cancer. These are estimated to reach USD 458 billion globally by 2030, and cut the projected global economic cost of cancers, estimated at USD 25.2 trillion for the period 2020-2050.

Such investments in services must be accompanied by clear communication about the necessity and benefits of such measures. It is also critical that the general public have access to reliable information on possible early signs of certain cancers (notably, breast, cervical, lung, prostate, ovarian and testicular) and primary healthcare staff must be equipped to spot signs of cancer – with rapid referral options for screening and then treatment.

Unfortunately, many people around the world still lack access to these essential services. In low- and middle-income countries in particular, cancer prevention, diagnosis and care remain a luxury that is out of reach for many.

A significant number of people, particularly those from low-income communities, face barriers that prevent them from accessing necessary health services, such as the distance to healthcare facilities and costs of healthcare – with the risk of financial toxicity if they must be paid for out of pocket.

A weak health system and an absence of knowledgeable healthcare providers can also stand in the way of timely cancer detection and diagnosis.

To close these gaps, routine screening, cancer diagnosis and referral services must be included in health insurance benefits packages.

UHC cannot be achieved unless everyone has access to affordable cancer care. At the same time, without the benefits offered by UHC, access to potentially life-saving screenings remains limited. This means someone may die of a cancer that could have been detected and treated at an earlier stage, but either an early detection programme was not available or that person could not access it, for financial or other reasons. A cost-efficient national cancer control plan with essential services – including routine screening and diagnosis – covered by national health insurance schemes available to everyone – can break down these barriers to accessibility, availability and affordability.

Indeed, often cancer treatment by national health insurance schemes but not screening. Issues of stigma that surround many cancer tests (for instance, those that concern sexual organs) therefore compound concerns about cost or fears of a diagnosis (e.g. cancer may be considered a death sentence, so why get tested?) to prevent high numbers of people getting a timely diagnosis, resulting in many patients presenting with late-stage cancers.

At the second High-level Meeting on Universal Health Coverage taking place on 21 September 2023, Governments are expected to adopt a set of new commitments to accelerate UHC implementation. This meeting will provide an opportunity for UICC to advocate for including comprehensive cancer prevention and control measures in UHC benefits packages.

In preparation for this pivotal meeting, UICC reached out to its members to learn about their concerns and inform its advocacy strategy in the lead-up to the UN HLM on UHC.

UICC is also organising a series of Virtual Dialogues intended to facilitate discussions around UHC and its impact on cancer control. The first dialogue organised in early May looked at UHC and prevention. A second Virtual Dialogue on UHC and early detection will take place on 20 July, and look at examples of successful advocacy to include screening and early detection in UHC benefit packages (for instance, mammography reimbursement in Algeria) and the use of legislation to support screening and early detection programmes and referral to treatment.

Learn more about UHC and cancer