Can your boss help you fight cancer?
Cancer is now so common that, some companies are offering checks and education programmes in staff benefits packages. Lisa Salmon reports
THE term company benefits usually conjures thoughts of a company car, perhaps private health insurance and dental care if you're lucky. For some workers however, checks against cancer might be on the cards too.
Cancer rates are rising – estimates now suggest that around half of us will be diagnosed with the disease during our lifetime. And although cancer is more common as people get older, more than 100,000 people of working age are diagnosed in the UK each year, with more than 700,000 people living with cancer below retirement age.
There are already screening programmes for breast, bowel and cervical cancers – though they are only for the age groups and genders for whom the benefits of screening have been shown to outweigh negative possibilities, such as false positive results and the anxiety that can cause – and now some private companies are taking it upon themselves to provide cancer education and screening for their employees.
PERKS OF THE JOB
The health screening firm Check4Cancer (Check4Cancer.com) offers cancer education programmes and early diagnosis opportunities for staff at participating companies, delivering personal cancer risk assessments based on family history and lifestyle, plus age and risk-specific early cancer detection tests for cervical, skin, breast, bowel, lung and prostate cancers.
These include blood tests for prostate cancer, skin checks by a specialist nurse for skin cancer, and tuition in self-examination and a breast examination for breast cancer. Age and personal risk may also indicate a mammogram, which can be performed with mobile equipment for large corporate programmes.
Staff with abnormal test results are either directed to a network of specialists if privately insured, or provided with results to be referred to an NHS specialist by their GP. Companies can pay to take part in the scheme themselves, or give staff the option of contributing through salary sacrifice.
A recent Check4Cancer survey of HR staff found that 95 per cent backed the need for regular, free cancer checks for all employees, and 63 per cent planned to introduce cancer awareness programmes and/or screening in their organisation.
Cancer surgeon Professor Gordon Wishart, medical director at Check4Cancer, believes demand exists because there's "an epidemic of cancer", with around 325,000 Britons diagnosed with the disease every year, and 160,000 dying from it annually.
However, cancer survival rates have doubled in the last decade, and 50 per cent now survive 10 years after diagnosis.
"Better education, increased awareness and improved methods of early detection are taking effect," says Wishart. "The rise in numbers of people with cancer is an issue for society as a whole – for government, health services, and increasingly for employers."
Wishart says the World Health Organisation states that a third of cancers are preventable through changes in lifestyle, such as stopping smoking, cutting obesity, eating a healthy diet and exercising, and a further third could be avoided through the introduction of effective early detection and education programmes.
"If we consider this in relation to educational services and targeted early detection programmes, the potential exists for employers to reduce cancer by up to two-thirds within their workforce," he says.
While raising awareness of symptoms, highlighting risks and promoting early detection have proven benefits, cancer screening isn't necessarily the best option for all people.
Sarah Williams, health information manager at Cancer Research UK, points out that some people will get false positive results from screenings, and will sometimes receive unnecessary treatment as a result.
She says the three national screening programmes were introduced following good evidence that such targeted services saves lives.
"On the whole, we think the benefits of this screening outweigh any harm from false positives or negatives, people being overly anxious or overly reassured, or finding cancer that didn't need to be treated," she says.
"[But] There are downsides to screening, and it's really important to remember that. Screening is for healthy people who have no reason to think they have cancer, and it's vital that we're overall doing more good than harm with it."
Cervical screening is estimated to save around 5,000 lives a year, often by preventing cancer from starting in the first place by treating abnormal cells detected in smear tests.
Breast cancer screening is thought to save around 1,300 lives annually. Although a 2012 review found that for every breast cancer death prevented through screening, around three women have treatment for a slow-growing cancer that wouldn't have caused them problems, it concluded that the benefits of breast screening outweigh the risks of over-diagnosis.
Bowel screening was introduced later than the other programmes, from 2006 to 2010, and while it's still too early to say how many lives it's saved, estimates suggest that by 2020, it will have cut annual bowel cancer deaths by about 2,000.
Other possibilities for screening programmes, such as testing PSA (prostate specific antigen) levels in the blood for prostate cancer, are not felt to be reliable enough to be used in a national screening programme, says Williams. A raised PSA level can be a sign of prostate cancer, but around three-quarters of men with raised PSA don't have prostate cancer, and some men with a normal PSA level do have the disease.
While imaging techniques like CT and MRI scans can help diagnose cancer, Williams says they're not recommended as a screening technique for healthy people who have no reason to believe there's anything wrong with them.
"None of us are perfect and we all have weird bits that don't matter, but once they see them on a scan, doctors may think they need more investigation, so people can end up having lots of extra tests and often, there's nothing wrong with them.
"And with a lot of these tests you're being exposed to radiation, which can lead to an increased risk of cancer, so it's probably not a good idea to be having them without a good medical reason."
A WORKING FORCE
Williams says workplaces can provide a good opportunity for experts to talk to people about cancer and help them understand how to reduce their risk and get prompt treatment for any possible symptoms.
She says CRUK sometimes visits companies to give such information to staff. "We'll talk to them about things like having a healthy lifestyle and how that can make a huge difference to reducing the risk of disease," she explains.
"It's about encouraging people to get to know their bodies, so if they notice anything different they'll go to the doctor, and helping people understand more about cancer."