Cancer Cases on the Rise: Here's What Employers Should Know

​The COVID-19 pandemic put a pause on many previously routine aspects of our lives. For some people, that included preventive medical care.

Limited in-person services, lockdowns and fear of contracting the virus resulted in sharp decreases in preventive health screenings, including those for cancer. These delays meant the disease could be more advanced at the time of detection, making treatment more arduous.

Snezana Mahon, chief operating officer at health company Transcarent in San Francisco, said these delays have created a "cancer tsunami."

"The 'cancer tsunami' refers to the massive number of patients expected to present at later stages of cancer when it's more complex and costly," Mahon said. "It's also suspected to be the No. 1 cause of death by 2025."

In March 2020, researchers at the University of Cincinnati Cancer Center found that the pandemic postponed more than 800 lung cancer screenings. When screening resumed three months later, the percentage of people tested who had lung nodules that were suspicious for cancer had grown from 8 percent before the pandemic to 29 percent.

What Work Is Like for Employees with Cancer

Rebecca Nellis, executive director of awareness organization Cancer and Careers, said employees with cancer face several challenges in the workplace—including whether or not to disclose their diagnosis to colleagues.

"With either choice, there are tons of questions and consequences to consider, including treatment side effects [and] workplace culture and the law," Nellis said. "The fear of losing one's job is real, as well as being treated differently or unfairly."

These concerns are heightened for Black and Hispanic employees, as research shows that cancer disproportionately impacts communities of color:

• Black individuals in the U.S. have higher death rates than all other racial or ethnic groups for many cancer types.
• Black women are 41 percent more likely to die from breast cancer than white women, despite lower incidence of the disease.
• American Indian and Alaska Native people have much higher rates of getting several cancers, including lung, colorectal, liver, stomach and kidney cancers, compared with non-Hispanic white people in the U.S.

The American Cancer Society projects about 224,080 new cancer cases and 73,680 cancer deaths to occur among Black people in 2022.

"These higher mortality rates, paired with the higher risk of discrimination in the workplace—and even in the health care system—can heighten the stress around a cancer diagnosis for an employee of color," Mahon said.

Individuals and their families must also face the reality of the cost of care. As the complexity of the treatment required increases, typically, so does the financial burden. In 2019, the national patient economic burden associated with cancer was $21 billion, according to a report published in the Journal of the National Cancer Institute.

"Misperceptions about what a particular cancer diagnosis means and requires is often another stumbling block for survivors who have to work or want to work," Nellis explained.

For example, some employers assume people with cancer do not want to work or are too ill to work, she said. However, Cancer and Careers research indicates that about 7 in 10 people who have been diagnosed with cancer prefer to continue working during treatment.

"The benefits of working include necessities like a paycheck and insurance, but also feelings of normalcy, identity, routine, productivity and community," Nellis said.

The Role of Employers

Employers should be ready for a significant increase in costs due to the demand in care for cancer. Cancer treatment is expected to average $10,000 per month for each patient and account for greater than 25 percent of high-cost health insurance claims by 2025, Mahon said.

"For employees, it's nearly impossible to have cancer and 'navigate' the health care system and their lives all at the same time," Mahon explained. "Employers need to consider a solution that prevents unnecessary stress, recovery delays and costs for employees."

Employers can help ease the minds and worries of an employee diagnosed with cancer by:

• Allowing a flexible work schedule to accommodate doctor's appointments, treatments and rest.
• Encouraging time off—from sick leave and paid time off to short-term disability, depending on the person's needs.
• Checking in with the employee. Create a safe environment for the employee to be honest with their teams and managers about what they need, and try to accommodate those needs.
• Sharing a simple but robust list of resources available to them through their benefits packages.
• Providing instructions for how to access their benefits.

Companies should also assess their current benefits packages and ask themselves:

• Do we have the right tools and resources available to support the mental health and well-being of someone diagnosed with cancer?
• Do we make navigating health care simple and easy for the employee?
• Does our health plan offer access to a range of reputable cancer centers with high-quality services?
• How can our benefits help to relieve some financial burden from our employees?

"When a colleague is diagnosed with cancer, confidentiality and flexibility are key," said Kristina Thomson, senior director of health systems for the American Cancer Society. "Supervisors can support the employee by focusing on plans for how work will get done rather than on the person's medical condition."