1. The Impact of Cancer on a Future NHI
National Health Insurance Policy Brief 5
The Impact of Cancer on a Future NHI
20 August 2009

2. Incidence of Cancers 2009 T
Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

3. SAHR Cancer Deaths by Type 2001 to 2005
Day C, Gray A. Health and Related Indicators. In: Harrison S, Bhana R, Ntuli A, eds. South African Health Review Durban: Health Systems Trust; URL:
Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

4. SAHR Cancer Deaths by Type and Province in 2005
Day C, Gray A. Health and Related Indicators. In: Harrison S, Bhana R, Ntuli A, eds. South African Health Review Durban: Health Systems Trust; URL:
Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

5. Expected Incidence and Survival Prevalence South Africa
Cancers for all sites except skin shown, using data from GLOBOCAN 2002
Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

6. Incidence and One-year Survival 1994 to 2025
Uses ASSA2003 population with GLOBOCAN 2002 rates. Cancers for all sites except skin shown.
Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

7. Incidence and Three-year Survival 1994 to 2025
Uses ASSA2003 population with GLOBOCAN 2002 rates. Cancers for all sites except skin shown.
Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

8. Incidence and Five-year Survival 1994 to 2025
Uses ASSA2003 population with GLOBOCAN 2002 rates. Cancers for all sites except skin shown.
Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

9. Incidence 1994 to 2025
Uses ASSA2003 population with GLOBOCAN 2002 rates. Cancers for all sites except skin shown.
Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

10. Impact of Cancer on National Health Insurance
GLOBOCAN 2002 incidence and survival prevalence rates by age and gender tested with local oncology group and found to be consistent with their practise experience and other literature.
Combined with ASSA2003 population projections to 2025 to show expected increase in cancer due to growth and aging of population.
Number of people in SA diagnosed with cancer for all sites except skin is estimated to have been 53,310 in 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).
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 are not brought through into the estimates. This needs further research.
Source: IMSA NHI Policy Brief 5: Cancer and Future NHI

11. Planning a Cancer Service for a National Health System
UK National Health Service:
Primary care is seen as the focus of care.
Designated Cancer Units in many district general hospitals. Sufficient expertise and facilities to manage commoner cancers – surgically led service.
Designated Cancer Centres provide expertise in management of all cancers, including common cancers nearby and less common cancers by referral from Cancer Units. Normally serve population of more than 1,000,000. Paediatric and adolescent cancer services; rare cancers; plastic and reconstructive surgery; intensive chemotherapy and bone marrow transplantation; full range of radiotherapy facilities; medical oncology; sophisticated diagnostic facilities (pathology and imaging); and special expertise in palliative care and rehabilitation.

12. Innovative Medicines South Africa (IMSA) is a pharmaceutical industry association promoting the value of medicine innovation in healthcare. IMSA and its member companies are working towards the development of a National Health Insurance system with universal coverage and sustainable access to innovative research-based healthcare.
Contact details: Val Beaumont (Executive Director) Tel: Fax:
Innovative Medicines SA (IMSA) Cell:
PO Box 2008, Houghton, South Africa

13. Professor Heather McLeod
Material produced for IMSA by
Professor Heather McLeod