National Health Insurance
The Impact of Cancer on a Future NHI 

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In an introduction to life-style induced cancer in South Africa, the authors found “Worldwide, there were approximately 10.1 million new cases, 6.2 million deaths and 22.4 million persons living with cancer in the year 2000.1 This represents an increase of 19% in incidence and 18% in mortality since 1990, in keeping with population growth and ageing.”

In South Africa, the expected growth in population numbers and expected aging of the population has a significant effect on the future burden of cancer. Using the GLOBOCAN 2002 rates of incidence and the ASSA2003 population to 2025, the number of people in South Africa diagnosed with cancer for all sites except skin is estimated to have been 53,310 in 1994. By 2009 the annual incidence is 74,431 (an increase of 40%) and by 2025 the incidence could be 93,060 cases (an increase of 75% since 1994). This is illustrated graphically overleaf. The table shows the impact on different sites of cancer. Note however that the GLOBOCAN 2002 rates are not separated by socio-economic class and so the effects of poverty on the site of cancer, as discussed above, are not brought through into the estimates. This could be a useful future academic research project.

Figure 3: Estimated Incidence and Three-year Survival Prevalence of Cancer in South Africa 1994 to 2025

Table 1: Expected Incidence of Cancer in South Africa 1994 to 2025 by site of Cancer, using GLOBOCAN 2002 with ASSA2003 population projections

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