Leading employers Hewlett Packard and Lend Lease are showing how organisations can take a proactive approach to managing cancer in the workplace. Stephen Hackett discusses why this is necessary.
We know there are four major health risks currently facing employers – mental health, musculoskeletal disorders, heart problems and cancer – and that these are increasingly serious issues. Could it become an unspoken recruitment bias, for example, that a man over 40 is 50% more likely to have to manage cancer? What can employers do to support the 560,000 people living with cancer in the workforce today? How does it affect the teams around them, hiring replacements or productivity? What about the 35 million days lost due to musculoskeletal problems annually, or the fact that one in three employees will feel debilitating stress in the next one to two years?
As the cost of providing health-related benefits continues to rise, creative broking alone is no longer sufficient to keep costs down. Employers need to take a proactive approach, looking at the root causes of the cost increases and find ways to make long-term, sustainable improvements to employee health.
Early detection is key
At a seminar in October 2014, organised by health insurer Aon, experts and practitioners discussed what can be done to tackle one of these key health risks – cancer. With more than 325,000 people of working age being diagnosed every year, there are few employers who are not touched by the condition, whether it is their employees suffering directly or their employees’ family members.
As cancer incidence reaches a record high, the Department of Health has asked for the support of employers in the early detection of cancers in its national plan, “Improving outcomes”. Research shows that the early detection of cancer can lead to better treatment options, improved survival rates, as well as making a direct and positive difference to employees’ lives. Early detection and cancer screening services can also impact directly on an employer’s bottom line by reducing absence, getting affected employees back to work more quickly and lowering private medical insurance and income protection costs.
Indeed, a report from Cancer Research UK in September 2014 revealed that 46% of cancers are diagnosed at an advanced stage, when they are harder to treat successfully, and that early diagnosis of all cancers could improve chances of successful treatment – and relieve a huge cost burden for the UK.
The research showed that the overall saving could be as great as £210 million, while also helping to improve the survival prospects for more than 52,000 patients. These potential benefits and savings are even larger when the expected growth in the number of people who will be diagnosed with cancer over the next 15 years is taken into account.
“Nothing demonstrates this more clearly than the very different outcomes we see with two of the most common cancers – breast and lung cancer,” explained Gordon Wishart, professor of cancer surgery and medical director at cancer screening specialists, HealthScreen UK, speaking at the “Managing cancer in the workplace” seminar. “Although breast cancer is increasing, the mortality rate has actually been falling since the 1980s. We are doing well in terms of early diagnosis and treatment, not just because specialist screening is available, but because of better education and awareness.”
By contrast, survival rates for lung cancer are very poor and late detection is the fundamental issue. The lack of a national screening programme for lung cancer means that 90% of cases come to light as a result of symptoms, by which time it is often too late for surgery or other curative treatments. But, if lung cancer could be picked up as early as breast cancer, then there is no reason why a similar survival rate could not be achieved.
Ways to test for cancer at work
There is now a simple blood test that detects seven antibodies made by the body in response to lung cancer at a very early stage. NHS Scotland is running a randomised trial of 5,000 men at high risk with a control group of 5,000, comparing numbers of advanced lung cancers that present in both groups. Recruitment to the study continues and this test has real potential to pick up lung cancers at a stage where they are more treatable.
Similar opportunities exist with regard to prostate cancer and bowel cancer. Current tests used by the NHS for prostate cancer are not very reliable, missing some cases and giving false positives, which can result in unnecessary biopsies. More accurate blood tests, such as the ones used by HealthScreen UK, are now able to pick up prostate cancer at an early stage.
This highlights the major cost issue here. The Cancer Research UK report, for example, found that treating colon cancer at its earliest stage costs £3,373 compared with £12,519 when treated at its latest stage, evidence that taking proactive steps to encourage early detection can also pay off.
What employers can do
The take-away from the seminar was that the way forward is not just about screening, but also about education and awareness.
Employers can take positive action to increase awareness of cancer, initiating early screening programmes within the workplace and educating employees on managing risk factors and spotting symptoms. These programmes can operate at a number of levels from awareness and knowledge-based campaigns via dedicated seminars, websites, posters and information brochures through to a full-scale company-wide cancer screening programme.
Hewlett Packard (HP), for example, have conducted workplace-based screening programmes for four of the most common cancers – breast, prostate, skin and lung. In each of these campaigns, anomalies were detected that otherwise may only have been picked up much later or not at all, ultimately having life-changing consequences for the affected employees.
Mark Osborn, HP’s total reward manager, highlighted HP’s cancer awareness and detection strategy, in the “Power of prevention” campaign: “We set out with four key objectives: to raise awareness of cancer throughout the entire workforce; to ensure that people understood their own risk, via personal online assessment; to provide education, running a number of sessions across HP sites using specialists; and to identify cancers through a corporate screening programme. This was paid for by the company itself and was targeted not only at employees but also partners of employees.
“The campaigns were a great success, with around 10,000 employees being screened in total – that is about 27% of the eligible population. Within that, the prostate and breast cancer campaigns reached over 40% of the eligible workforce. From the screenings, over 1,000 cases were referred for further investigation, in partnership with HealthScreen UK. These ultimately resulted in 65 cancers being detected early among employees or their partners and we noted that within these were a handful of cases that had been missed by NHS screening.
“The business outcomes of the screening campaign are ongoing, but it will mean reduced cost pressures on HP’s medical scheme in the long term. Previously, the average cost of cancer treatment through a private medical scheme had been around £30,000 per employee, but already we are seeing lower average costs. We also expect to see a long-term reduction in absence costs, as well as early retirement and life assurance premiums. We have also seen an increase in employee engagement, which is up 13% during the years in which the campaigns were run.”
Lend Lease is another organisation that has seen the benefit of cancer screening. It is an Australian property company that operates in Europe, the Americas, Asia and Australia. The nature of the work means that 18% of the workforce operate outdoors, on site, which presents very specific challenges for dealing with their health and welfare, something which was compounded when a healthcheck offered via the Lend Lease Foundation – which was set up by the company’s founders to invest in employees, their families and communities – revealed that 52% of staff did not protect themselves in the sun.
Gemma Bourne, head of corporate social responsibility at Lend Lease (EMEA), explains: “Given the rising levels of skin cancer, this finding was alarming for the business and prompted us to consider how to tackle the problem with maximum flexibility and convenience for employees. We wanted to offer employees skin cancer screenings at their place of work. Sessions took just 30 minutes and were conducted in ‘pop-up’ clinics in specially prepared offices and portakabins. This not only screened participating employees for cancer but also educated the workforce on the wider impact of skin damage from the sun, revealing ‘invisible’ damage using advanced imaging equipment.”
Uptake for the Lend Lease cancer screening programme exceeded the company’s expectations: the 200 places initially offered were booked up within an hour of going online, so the number was quickly doubled to 400. Next year, the company plans to make 800 slots available for employees.
Bourne added: “Feedback from staff has also been overwhelmingly positive. One of the key factors in making it such a success was the accessibility and convenience of having the checks on site, allowing employees to easily take up the opportunity without their working day being interrupted. In total, 365 of our employees were given the all clear, with 23 requiring further checks and several being referred for urgent action.”
The role of employers in taking positive action to increase awareness of cancer can clearly be seen in the experiences of these two organisations. Osborn sums up the role of employers when responding to this issue: “Companies do have a role in informing, educating and raising awareness of cancer in the workplace among its employees. It is something that affects us all, and companies absolutely can play their part in fighting cancer. We had feedback sent to HP that was truly humbling for all of us who read it. If you save just one person’s life, then the campaign was absolutely worthwhile.”
Aon Employee Benefits’ annual Employee Benefits and Trends Survey found that 75% of employers are not managing employee health risks now, but the tide is changing, with half of HR workers increasingly wanting to understand how employee health affects business performance and insurance premiums.
Serious illness can hit an employer hard, potentially impacting recruitment, retention, productivity, motivation, health programmes and, of course, rising insurance costs. HR has powerful data to help employees and employers. Increasingly, companies want to unlock this information so that effective strategies for business and individuals can be put in place.
Aon Employee Benefits & Trends Survey. Sept 2014.
Saving lives, averting costs – An analysis of the financial implications of achieving earlier diagnosis of colorectal, lung and ovarian cancer. Cancer Research UK, Incisive Health. Sept 2014.