Cancer screening in the UK:
Why it matters for life & health insurers
Image: Соня Монштейн- stock.adobe.com
Cancer remains one of the most significant health challenges in the UK. Around one in two people will be diagnosed with cancer during their lifetime, and it is a leading cause of death at working ages. At the same time, approaches to detection and diagnosis are evolving, with increased emphasis on earlier detection, targeted screening and the use of new technologies. In this article, Vicky Webb, Head of Biometric Research at the Hannover Re UK Life Branch, explores how screening practices are changing across major cancer types and highlights the potential implications for life and critical illness insurance, from claims experience to longer‑term risk assessment.
In early 2026, Cancer Research UK reported that cancer death rates had fallen by around 11% over the past decade, reaching record lows. This improvement reflects a combination of prevention, earlier diagnosis and better treatment.[1]
Cancer continues to be a central focus for the NHS. Its recently published National Cancer Plan sets out an ambition to save hundreds of thousands of lives over the next decade through earlier detection and innovation in care.[2]
For insurers, developments in cancer screening and diagnosis are particularly important. Cancer is the leading cause of critical illness (CI) claims and a major contributor to mortality. In insured populations, lower levels of cardiovascular and substance‑related mortality mean cancer accounts for a larger share of overall claims than might be expected from the general population.
For life insurance, earlier detection and diagnosis generally support mortality improvements (i.e. fewer future claims), by improving survival chances.
For critical illness insurance, the impact is less clear-cut. Earlier detection and subsequent treatment may:
- prevent progression to a full claim,
- result in partial or additional claims instead of full claims, or
- accelerate the timing of claims.
Monitoring developments in screening and diagnosis helps insurers to better estimate future trends and interpret past claims experience.
Screening trends by cancer type
Jump to section:
- Bowel cancer: screening and diagnosis have evolved over 20 years
- Breast cancer screening: targeted approaches and increasing capacity
- Cervical cancer: prevention and early detection has transformed outcomes
- Prostate cancer screening: a changing landscape
- Lung cancer screening: a promising start
- Oesophageal cancer: emerging screening innovations
Bowel cancer: screening and diagnosis have evolved over 20 years
Bowel cancer trends have shown a mixed picture in recent years. Incidence has been rising at ages below 50, while at older ages (particularly those targeted by national screening programmes) rates have been stable or falling.[3]
Screening plays a key role in identifying pre-cancerous lesions, which can be removed before progressing to cancer. Over time, this should reduce overall incidence, although in the short term it may lead to higher detection of early, asymptomatic cancers.
Bowel cancer screening was introduced in the UK in 2006 for people aged 60-74, with coverage increasing gradually over time. Screening initially used a ‘guaiac faecal occult blood test’ (gFOBT). From 2019, the introduction of the less invasive ‘faecal immunochemical test’ (FIT) led to a significant improvement in participation, with uptake in England increasing by around 10% over the following three years. Participation in England exceeded 67% in 2023/24.[4]
Since 2021, screening has been extended to those aged 50–74. This, along with further improvements to the sensitivity of FIT is expected to drive more and earlier diagnoses. Over time, screening is also likely to become more targeted, combining test results with wider risk factors to identify those at highest risk.
Faecal Occult Blood Tests (FOBT) uptake by year, England, screening year ending March 2007 to the year ending March 2024.[5]
The graph to the left includes both gFOBTs and FITs (which are both different types of FOBTs).
The “saw‑tooth” pattern observed in the pre‑2019 annual data reflects the phased rollout of the screening programme, which resulted in different proportions of previously screened individuals being invited in alternate years.
Breast cancer screening: targeted approaches and increasing capacity
Breast cancer remains the most common cancer among women in the UK.[6] Screening has been established for several decades and has also been clearly reflected in CI experience for some time.[7]
Looking ahead, the NHS plans to use emerging trial evidence to support more targeted cancer screening for women at higher risk, including those with dense breast tissue (BRAID trial) or differing HPV vaccination status.[8]
It will also consider the results of the GBP 11m NIHR‑funded EDITH trial, launched in April 2025, which is testing AI-enabled mammography that could allow a single specialist to replace the current two‑reader process.[9] If successful, this could release hundreds of radiologists and specialists nationwide, supporting increased screening capacity and reduced waiting times.
Cervical cancer: prevention and early detection has transformed outcomes
Nearly all cervical cancers are caused by infection with certain high‑risk types of human papillomavirus (HPV). Screening helps prevent cancer by detecting HPV infection or abnormal cervical cells at an early, more treatable stage, reducing both the incidence of invasive disease and cervical cancer deaths.
Incredibly, cervical screening was introduced in England in the 1960's!
Public awareness has been shown to significantly influence screening uptake. In 2008, the diagnosis and death of a reality TV star, which attracted nationwide attention, led to a widely reported surge in attendances, with around half a million additional screening appointments in England following the event.[10]
According to Cancer Research UK, cervical cancer has seen one of the biggest improvements across cancer types:
Reduction in cervical cancer death rates over the past 50 years in the UK
Of cervical cancer cases are expected to be prevented by the HPV vaccine, following its introduction in 2008.
People in the UK have now received the HPV vaccine
Prostate cancer screening: a changing landscape
The PSA test is a blood test that measures levels of prostate‑specific antigen, a protein produced by both normal prostate tissue and prostate cancer cells. While widely used in clinical practice, PSA testing is not currently recommended for routine population screening in the UK, following the UK National Screening Committee’s (UK NCS) most recent review.[11] This reflects long‑standing concerns that PSA testing is not sufficiently accurate for screening purposes, with risks of false positives, missed cancers and significant over‑diagnosis, and there is no clear evidence that PSA screening reduces prostate cancer mortality.
However, the future direction of prostate cancer screening is one to watch. Under the National Cancer Plan the government has committed to implementing prostate cancer screening where evidence supports it, with a clear shift towards genomic risk and targeted screening, rather than population‑wide programmes.
For example, men with BRCA1 or BRCA2 gene variants are 5-7 times more likely to develop prostate cancer, often at a younger age and with more aggressive disease. The UK NSC consulted in late 2025 on screening these men every two years between ages 45-61.
Alongside this, the NHS is supporting the TRANSFORM trial, which aims to identify more effective screening approaches by combining genetic testing with diagnostics such as MRI scans, rather than relying solely on PSA testing.[12]
Lung cancer screening: a promising start
Lung cancer remains one of the most common cancers in the UK and is most strongly associated with smoking, although other factors such as passive smoking and environmental exposures also play a role. As smoking rates continue to decline in many countries, a growing proportion of lung cancer cases are now occurring in people who have never smoked. In insured populations, where smoking prevalence is typically lower than in the general population, lung cancer‑related claims tend to be less frequent than population data alone might suggest, but will still contribute to claims experience.
A major recent development is the introduction of the UK Lung Cancer Screening Programme in 2023, targeting high‑risk individuals such as current and former smokers aged 55–74.[13]
The programme is already proving transformational, with around three‑quarters of cancers detected at an early stage, compared with around 30% outside the programme, and with clear benefits in reducing inequalities in early diagnosis.
The NHS plans to complete national roll‑out by 2030, with the expectation of diagnosing more cancers earlier and saving thousands of lives. In addition, trials are under way to assess whether lung CT scans can be extended to detect other smoking‑related cancers, with potential for wider adoption if shown to be cost‑effective.
Oesophageal cancer: emerging screening innovations
most common cancer in the UK is oesophageal cancer.[14]
There is currently no national population screening programme for oesophageal cancer in the UK. However, the National Cancer Plan highlights an innovative approach that could support more targeted detection. This includes a heartburn health‑check service set to be piloted in selected community pharmacies, using the capsule sponge test. The test involves patients swallowing a small capsule‑shaped device containing a sponge, which collects cell samples for analysis and is then gently retrieved using an attached thread. This simple, non‑endoscopic test is designed to detect early oesophageal cancer and the pre‑cancerous condition Barrett’s oesophagus. Participating pharmacies will be able to refer individuals who meet defined risk criteria directly into secondary care and may also proactively identify people at higher risk, for example those who frequently purchase heartburn medications.
Conclusion
Effective screening and diagnosis have been central in the fight against cancer and will remain an important focus for research, investment and health policy in the years ahead. The developments outlined here point to a growing focus on targeted, risk‑led detection, supported by incremental expansion of existing screening programmes and technology‑driven improvements, rather than sudden shifts in universal population screening.
For life and health insurers, this reinforces the importance of ongoing monitoring of screening and diagnostic advances, and of considering how changes in detection, disease mix and timing may influence both future claims experience and the interpretation of historical claims. As medical practice continues to evolve, claims definitions, underwriting assumptions and risk management tools may also need to adapt to ensure they remain aligned with the clinical reality.
Author
Vicky Webb
Head of Biometric Research
Hannover Re UK Life Branch
vicky.webb@hannover-re.com
References
1. Cancer Research UK. UK cancer death rates down to their lowest level on record. 9th March 2026. Available from: UK cancer death rates down to their lowest level on record - Cancer Research UK - Cancer News (viewed April 2026).
2. Department of Health and Social Care. The National Cancer Plan for England: delivering world class cancer care. Presented to Parliament by the Parliamentary Under-Secretary of State for Public Health and Prevention by Command of His Majesty. Available from: https://www.gov.uk/government/publications/national-cancer-plan-for-england (viewed April 2026).
3. Hannover Re. Colorectal cancer trends and insurance. June 2025. Available from: https://life-and-health-uk.hannover-re.com/colorectal-cancer-trends-and-insurance/ (viewed April 2026).
4. Department of Health and Social Care. Bowel cancer screening standards data report 2023–24. Available from: https://www.gov.uk/government/publications/bowel-cancer-screening-annual-report-2023-to-2024/bowel-cancer-screening-standards-data-report-2023-24 (viewed April 2026).
5. Department of Health and Social Care. Figure 3: Bowel cancer screening standards data report 2023–24. Available from: https://www.gov.uk/government/publications/bowel-cancer-screening-annual-report-2023-to-2024/bowel-cancer-screening-standards-data-report-2023-24 (viewed April 2026).
6. Cancer Research UK. Breast cancer statistics. Available from: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer (viewed April 2026).
Breast cancer screening: targeted approaches and increasing capacity image - Valerii Apetroaiei - stock.adobe.com
7. Hannover Re. UK insights on critical illness (ReCent report). January 2021. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwj55Zrn4_KTAxUsQkEAHUFhM2YQFnoECBoQAQ&url=https%3A%2F%2Fassets.hannover-re.com%2Fasset%2F533267266226%2Fdocument_f8u86ksi1t6s5bk2jsvrap1418%2F2021_01_LH_ReCent-UK-insights_critical-illness_en.pdf%3Fcontent-disposition%3Dinline&usg=AOvVaw1qUIWze5RapWMbEc9XCrUd&cshid=1776356566480854&opi=89978449 (viewed April 2026).
8. Health Research Authority. BRAID programme. Available from: https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/braid/ (viewed April 2026).
9. Department of Health and Social Care. World-leading AI trial to tackle breast cancer launched. Available from: https://www.gov.uk/government/news/world-leading-ai-trial-to-tackle-breast-cancer-launched (viewed April 2026).
10. National Library of Medicine. The impact of Jade Goody's diagnosis and death on the NHS Cervical Screening Programme. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3385661/ (viewed April 2026).
11. UK National Screening Committee. Prostate cancer screening recommendations. Available from: https://view-health-screening-recommendations.service.gov.uk/prostate-cancer/ (viewed April 2026).
12. Prostate Cancer UK. TRANSFORM trial. Available from: https://prostatecanceruk.org/research/transform-trial (viewed April 2026).
13. NHS England. Lung cancer screening. Available from: https://www.nhs.uk/tests-and-treatments/lung-cancer-screening/ (viewed April 2026).
Lung cancer screening: a promising start image - marc - adobe.stock.com
14. Cancer Research UK. Oesophageal cancer statistics. Available from: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/oesophageal-cancer (viewed April 2026).
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