Four out of five patients who present with breast cancer in South Africa in the private sector are likely to survive the disease – according to new data from the Independent Clinical Oncology Network (ICON). Clinical Executive at ICON, Dr Lee-Ann Jones, discusses how they have been gathering data on the incidence of breast cancer in the South African insured population, offering the most comprehensive snapshot of the disease yet.   

Early diagnosis and treatment of breast cancer is key to success, and advances in technology and awareness mean that more women are able to identify and successfully treat the disease before it is too late.

Gathering data

ICON is currently partnered with over 40 medical schemes across the country, including South Africa’s biggest medical scheme, Discovery Health, and represents more than 80% of the private sector oncology fraternity.

The network has been gathering data on cancer through its eAuth™ system, which speeds up treatment authorisation based on standardised treatment protocols, for several years from more than 3.5 million insured lives to create the most comprehensive snapshots of cancer care data in the country to date.

Any authorisation that’s submitted through our system is stored in a data warehouse. Therefore, we have access to the patient’s disease status, the staging, the treatments that they’ve had, and we’ll also have what their response to that treatment was. The system eliminates waste and unnecessary treatment and makes sure that the treatment is appropriate.

The eAuth™ software is intelligent and it links treatments to specific diagnosis. We’re the only system that does that.

Analysing the data

The ICON data for 2014 and 2015 was consistent with 83 and 84% of patients presenting with stage one to three of the disease, with less than one in five presented with incurable stage four of the disease.

The data further reveals that the incidence of breast cancer in South African women in the insured population is 110 per 100,000. Interestingly, this is very close to the US statistics which stand at 123 per 100,000.

Beyond being influenced by lifestyle choices and genetics, these numbers indicate that private healthcare in South Africa mirrors first world care. Patients have access to the screening and treatment services that you would expect in a first world country and schemes fund screenings like mammograms and breast examinations.

Using the data

While the ICON system is only able to look at the insured population, the data also has implications for how policy makers approach oncology more broadly.

One of the biggest challenges facing oncologists in the oncology fraternity, both in the public and private sectors, is the high cost of the new treatments. Our data is helping to show us which drugs work and which treatment protocols are most effective. This information will also have a bearing on South Africa’s uninsured population.

ICON also works with the Council of Medical Schemes (CMS) in defining the minimum benefit an insured patient should be entitled to, and with medical schemes, aligning scheme rules with ICON’s protocols as the basis to fund for cancer treatment.

A key take out from the ICON breast cancer data is that it underlines the importance of early screening and diagnosis and that more effort should be spent in raising awareness on the disease – especially in rural populations.

The best way to find pre-malignant, or very early stages of the disease, is through a breast examination or a mammogram, which will pick up disease without symptoms that the patient is unable to feel. Screenings are advised for every one to two years from the age of 40, so any subtle changes from one year to the next can be detected.

It’s important for women to discuss their breast cancer risk factors with their GPs to work out the best screening regimen, as women with genetic predispositions will have to start screening before they turn 40.

By the time you can feel the breast cancer tumour, it’s already approximately one-and-a-half to two centimetres in diameter. Those one in five patients who present with advanced disease are unlikely to have been undergoing regular screening.

October is breast cancer awareness month, so my message to women everywhere is if you haven’t already – take action and undergo screening.

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