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Cancer Diagnostics – Earlier Detection & Impact on Incidence & Mortality

In this, the second of our 4-part series of insurance-focused articles on cancer, Dr. Achim Regenauer, Chief Medical Officer, presents a high-level overview of liquid biopsy, one of the most exciting potential advances in cancer research. With promising results to-date for certain late-stage cancers, early and painless diagnosis from liquid biopsies could have huge positive consequences for wider cancer treatments and recoveries.

Dr. Regenauer’s content is presented in a concise bulleted format – so there’s no need for you to wade through complex medical descriptions or interpret sensationalised headlines.

Alongside the observations, Sohila Kwan, Head of Business Development, Life & Health APAC, adds valuable market insights and solutions relating to how the Life & Health insurance industry can adapt to these changes to stay relevant over the next decade.

What is liquid biopsy?

  • The simple detection of mainly genome-based biomarkers for the screening, diagnosis and treatment of cancers.
  • Not yet a reality in public health, but the expectation is for the detection of cancers on the basis of cell/DNA/RNA fragments from a simple blood test.
  • This will have a significant impact on the healthcare industry and wide implications for Life & Health insurers.

What’s new about this?

Cancer diagnosis has, until now, been done by taking a biopsy of the affected organ tissue to confirm the presence of a tumour. This is invasive (sometimes requiring surgery) and painful (needle puncture). In contrast, liquid biopsy may:

  • Enable early detection via a simple blood test.
  • Be repeatable, as required.
  • Give full insight into the molecular features of the cancer, even if localisation of the cancer is not yet clear.

Expected benefits

  • Easy, wide-scale screening for single or (better still) multiple cancers to detect cancers long before the first symptoms appear, i.e. at a time when the cancer is more likely to be curable.
  • Help to identify more effective treatment options for an individual (i.e. personalised medicine, based on the molecular insights).
  • Regular monitoring of advanced in-treatment cancers and detecting relapses at the earliest opportunity, increasing recovery outlook.

Business solution: A move to closer & more supportive relationships with customers

Liquid biopsy has the potential to deliver early, painless, easy to access cancer screening and diagnosis for all. Anticipation, therefore, is for increased, proactive screening amongst the general population, improved treatment outcomes and higher awareness and focus on lifestyle changes to reduce and manage cancer risk.

So, for insurers, not only could the risk change, but so too the insured’s perception of the risk. There is opportunity here for insurers to correspondingly change the way they provide the necessary support, i.e. for a fundamental shift in insurance solutions, a shift toward supporting customers throughout their life journey rather than just at inception, premium payment and claims.

This shift is in fact already underway in the insurance industry: Customers, for example, are already seeking greater value from their Critical Illness policies, including earlier stage diagnoses, support for prevention and disease risk management, and peace of mind that their coverage is keeping up with the latest advances in cancer research; furthermore, insurers are starting to offer disease prevention, health and wellness propositions that attach to the main protection product.


Expected impact on Life & Health insurers

  • Mortality improvements for specific or even most cancers (impacting Life and Longevity covers).
  • Cancer incidence and policy utilisation rates will increase and need review (impacting Critical Illness and Medical Reimbursement covers). Over the last few decades, diagnoses for cancer in-situ of the breast and cervix outpaced diagnoses of invasive breast and cervix cancers by 3 to 5 times1. Liquid biopsies will intensify this trend, up to overdiagnosis2.
  • Higher hospital costs in the first year after screening begins, partially relating to overdiagnosis.
  • Critical Illness products may require new diagnostic wordings to clarify and update claim definitions (cancers currently represent over 70% of Critical Illness claims).
  • Potential for adverse selection. In many markets it’s not clear, for example, whether liquid biopsy is part of genetic test bans.
  • Pricing based on historical experience will need to be reviewed to take the developments into account.

Business solution: The risks & opportunities ahead for insurers

For Life & Health insurers, the development of liquid biopsy represents both risks and opportunities:

  • Risks that Critical Illness products, including definitions, benefit design and pricing, don’t take into account the advent of liquid biopsy and its impacts on screening rates, diagnosis, actual impact to the insured and associated changes in customer behaviours. This could be particularly impactful in many Asian insurance markets as Critical Illness products are guaranteed on a long-term basis (i.e. 20+ years). Another potential risk is adverse selection, i.e. that customers avoid or lapse Critical Illness and/or Medical Reimbursement policies if a test result is negative and purchase cover if it’s positive. This is also a risk to the consumer, as there are many driving factors behind cancer and the test is only a snapshot of that moment in time, cancer could still develop later on.
  • Opportunities for growth from new, innovative Critical Illness products that address the gaps in current product design and reflect the benefits to consumers from advances such as liquid biopsy; for example, the aforementioned shift towards products enabling a closer and more supportive relationship with customers. Given potential mortality improvements, opportunities could also exist to adapt protection products for older ages.

In addition, liquid biopsy will potentially give customers sensitive personal and health-relevant information. In the absence of any clear regulation or guidelines on how the industry should or should not request and use this information, the related information asymmetry and data privacy issues present sensitive topics that the industry will need to navigate.


Business solution: Future-proofing your business

Liquid biopsy and its impacts on the industry is a good example of the importance of “future-proofing” life and health products and hence the growth and sustainability of your business.

Future-proofing means anticipating the future and developing methods of minimising the effects, shocks and stresses of future events. This is particularly relevant for the industry given that the overarching principles and construct of Critical Illness products have remained largely unchanged since it was first developed, and that medical advances are inextricably linked to consumer’ health and behaviours.

Future-proofing in the context of liquid biopsy and other advances not only means evolving the product range to ensure relevancy and customer value, correctly priced in the current and future environment, but also implementing effective monitoring, change and risk management frameworks to manage wider issues, such as data privacy, and enrichment of the control cycle for new initiatives where little if no experience data exists.


State-of-the-art – In process

  • Liquid biopsy is about to leave the domain of basic science.
  • Numerous clinical trials are underway to investigate and validate the monitoring of treatment responses and cancer recurrences with liquid biopsy, mainly for advanced cancers. One independent validation study of a multi-cancer liquid biopsy test3 has reported encouraging results, and larger population studies for this are now in process; read PartnerRe’s 2021 summary of the Galleri test sub-study.
  • The first liquid biopsies in clinical practice have until recently only been available for a few cancers; these are mainly at the research stage and are all for advanced stage 3-4 cancers. Multi-cancer testing also has significant challenges to overcome before entering mainstream clinical practice.
  • Headlines sometimes report multi-cancer screening tests and distort the advances, e.g. that the CancerSEEK test can screen for eight common cancers in a clinical setting. Currently, assays CancerSEEK, Galleri and PanSeer4 are still in development and, despite the abovementioned encouraging results for Galleri3 , do not yet have sufficient validation for routine use.

Business solution: Keep calm, monitor & carry on with expert support

It is important for the industry to be proactive about future-proofing Critical Illness business. However, it’s also important that the actions taken are measured and commensurate with the evolving risk and experience.

As you monitor the changes, working together with an expert reinsurance partner – with new products and global experience in innovative, sustainable solutions – can help you to prepare for the future.


Prediction for the next 10 years

  • As cancer is an umbrella term for a collection of related diseases, advances in clinical applications for patients with existing cancers (surveillance against recurrence) will be realistic (very likely) for a number of cancer types.
  • Screening of select cancers in healthy individuals may be feasible (likely).
  • A pan-cancer (all/most common cancers) test for mass screening is conceivable, but many challenges must first be overcome.

Business solution: How PartnerRe can help you

At PartnerRe, we recognise the importance of Critical Illness coverage to your business and customers, and – as advances change the way that we detect, treat and manage cancer – we want to support you in your goal of protecting your customers’ health, from financial protection to health improvement and disease prevention, including by investing earlier on in the customer health journey.

If understood well and proactively managed, advances in medical research, such liquid biopsy, create an opportunity to enrich the product and proposition for consumers to deliver effective, aligned solutions and certainty when it’s so critically needed.

Together with our global medical experts, we’re looking at new and sustainable Critical Illness product wordings, designs and pricing, as well as supporting services that are “future-proofed” to medical advances, such as liquid biopsy for cancer. We have been successful, for example, in developing an innovative, new-age product that replaces definitions with outcome-based cover wordings to align cancer benefits with need and at an affordable price. We would be delighted to partner with you to evolve this product further.

We’re here to support you as you deliver on your promises to your customers, backed by our risk and product expertise, capacity, security and long-term partnership approach.

We believe in the value of collaboration to listen to your needs, your concerns and your ambitions, to work together to analyse and support the risk and to realise the opportunities for you and your customers.



We hope you found this overview helpful.

Don’t miss the next article in this series on cancer treatments – “Part 3: Targeted Cancer Therapy – Road to Precision Medicine”, includes insights such as the first routine applications of precision medicine.


Our approach is one of partnership, shared expertise and the creation of success for our clients.

We look forward to discussing these trends and concepts with you, and to turning them into concrete solutions for your business.

Achim Regenauer, Chief Medical Officer, Europe and Asia Pacific
Sohila Kwan, Chief Marketing Officer, Life & Health, Asia Pacific

Opinions expressed are solely those of the author. This article is for general information, education and discussion purposes only. It does not constitute legal or professional advice and does not necessarily reflect, in whole or in part, any corporate position, opinion or view of PartnerRe or its affiliates.



2 Diagnosis of a medical condition that would never have caused any symptoms.



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