Underwriting breast cancer in 2017 will require an understanding of the current and growing role of genomics in the assessment of its mortality risk. This is not to lessen the importance of well-known prognosticators such as tumor/node/metastasis (TNM) staging, estrogen receptor/progesterone receptor (ER/PR) and human epidermal receptor growth factor 2 (HER2) receptor status, grade, or the mitotic activity index (MAI). Rather, it is to keep abreast of additional genomics-based prognostic tools that can be used to further stratify breast cancer and its risks.
We have made great progress in the battle against breast cancer: improved screening and treatment have produced a 30% reduction in mortality over the last two decades. Better still, continued advances in genomics are opening entirely new possibilities that hold the promise of not only improved outcomes, but an eventual cure. For life and health insurers, it is time to reexamine how we underwrite applicants with a history of breast cancer.
Genomics is at the forefront of a technological revolution in biomedicine and healthcare through which personalised treatment is fast becoming a reality. Genomics will improve care across a range of health problems and allow more targeted therapy. If insurance is indeed a pool into which participants pay sufficient to cover their risk, shouldn’t insurers have access to this genomic knowledge to use in equitable ways to benefit customers?