Readers are aware of the significant toll that cancer has on our society. We have all been touched on a personal level by cancer’s reach. According to the Centers for Disease Control and Prevention, cancer is the second leading cause of deaths in the U.S., trailing only very closely behind heart disease. Cancer has a similarly destructive impact on employer-sponsored health plan costs. According to the International Foundation survey Workplace Wellness Trends: 2017 Survey Results, the conditions that have the most impact on health plan costs are diabetes (41%), cancer (33%), arthritis/back/musculoskeletal issues (32%) and obesity (29%).

The primary causes of cancer are well-documented and include:

• Age
• Alcohol abuse
• Hormones
• Obesity (due to poor diet and lack of physical activity)
• Exposure to sunlight
• Tobacco use.

According to the World Health Organization, 30-50% of all cancer cases are preventable. Plan sponsors have taken this to heart and offer a wide range of initiatives that target these primary causes. According to the same Foundation survey results:

• Alcohol abuse—Commonly targeted through resources offered in an employee assistance program (EAP) (85%), various mental health initiatives (63%) and substance abuse treatment coverage/benefits (54%)
• Inactivity—Employers encourage increased physical activity through wellness competitions such as walking/fitness challenges (51%), office standing/walking workstations (42%) and activity/exercise breaks that are encouraged during work time (37%).
• Poor diet—Employers promote better choices through healthy food options in cafeterias or vending machines (44%) and nutrition counseling (32%).
• Tobacco use—Employers discourage smoking and other tobacco use through smoke-free worksite policies (66%) and smoking cessation programs (56%), including counseling, medication and nicotine patches.

Certificate Series—Health Benefit Plan Basics: September 26-27, 2018, Washington Hilton, Washington, D.C.

It is also important for your members to be aware of lesser known causes of cancer, of which there is still evolving research. These are highlighted below.

Asbestos—Asbestos is a mineral fiber found in rock and soil that has been used in building construction materials for insulation and as a fire retardant. Symptoms may take decades to develop, but exposure to asbestos significantly increases the risk of developing lung diseases like mesothelioma.

Poor indoor air quality—Volatile organic compounds (VOCs) are emitted as gases from certain solids and liquids including a variety of household items. These can include paints, solvents, wood preservatives, aerosol sprays, cleansers and disinfectants. Beyond cancer, health effects may include damage to the liver, kidneys and central nervous system.

Poor outdoor air quality—Similarly, outdoor air pollution has been identified as a leading cause of cancer deaths. Causes include diesel engine exhaust, solvents, metals and dusts. Studies have shown that the risk of developing lung cancer is significantly increased in people exposed to these pollutants.

While it is difficult for employers to target these sources specifically, steps that can be taken are testing for air quality and the presence of toxins, removing any potential sources and improving existing air conditions by introducing plants that can filter the air, opening windows or cleaning the HVAC system.

Justin Held, CEBS
Senior Research Analyst at the International Foundation