Russell Millison
Senior Vice President, Strategic Accounts Employee Health & Benefits
While the top three large claim categories impacting U.S. health plans include cardiovascular and musculoskeletal conditions, cancer remains the most significant and costly health risk facing U.S. employers.
According to Sun Life’s 2025 High-Cost Claims & Injectable Drug Trends Analysis, “malignant neoplasms” and “leukemia, lymphoma, and multiple myeloma” rank as the number one and number four high-cost claim conditions, respectively.
Additionally, Marsh McLennan Agency (MMA)’s Navigating Today’s Rising Oncology Costs “malignant neoplasms” and “leukemia, lymphoma, and multiple myeloma” rank as the number one and number four high-cost claim conditions, respectively.
While cancer mortality has declined over the past several decades due to advances in treatment, screening, and public health efforts, data from the American Cancer Society indicate that overall incidence remains high and is increasingly shifting toward working-age populations, women, and younger employees.
Independent analyses and academic research, as documented in the JAMA Health Forum’s article Launch and Postlaunch Price Developments of New Drugs, have shown substantial increases in the prices of certain cancer therapies over the past two decades—far outpacing general medical inflation.
Experts like MMA’s Chief Medical Officer Monte Masten, MD, MBA, MPH, FACOG, emphasize that speed matters. Delays in screening, diagnosis, or navigation are no longer just clinical risks—they directly drive cost volatility, workforce disruption, and long-term financial exposure for employers. This underscores that cancer is no longer a distant or unpredictable issue but a core factor influencing healthcare spend, productivity, retention, and benefit sustainability.
All employers—fully insured or self-funded—should care about cancer because it increasingly affects employees during their working years, disrupts productivity and retention, and requires thoughtful support across screening, treatment, and return-to-work planning.
According to Sun Life’s 2025 analysis, cancer consistently ranks among the highest-cost medical conditions in employer-sponsored health plans, both by total spend and number of affected members.
“Malignant neoplasm remains the leading high-cost claim condition by both total spend and number of affected members,” as reported by Sun Life’s 2025 High-Cost Claims & Injectable Drug Trends Analysis.
These costs rarely emerge gradually. Instead, they often arrive through a single diagnosis that reshapes a year’s healthcare spend. Late-stage diagnoses requiring intensive treatment, prolonged care timelines, and the rapid growth of specialty oncology drugs—particularly immunotherapies—combine to create outsized financial impact. From a volatility standpoint, cancer is a primary driver of catastrophic and million-dollar claims, as well as specialty pharmacy spend.
We believe that employers who invest in early detection, education, and coordinated navigation may materially improve employee outcomes while mitigating downstream cost escalation and volatility.
The cancer landscape: past and present trends
Progress in survival, not in incidence
According to the American Cancer Society’s Cancer Facts & Figures 2025, the age-adjusted cancer death rate declined by about 34% from its peak in 1991 through 2022 in the United States. This decline reflects long-term reductions in smoking, early detection, and advances in treatment that have averted millions of deaths.
However, declining mortality does not equate to declining employer risk. Improved survival means more employees living longer with cancer—often requiring extended, complex, and costly treatment. From an employer perspective, cancer has increasingly become a chronic condition with long-term workforce and cost implications.
A growing impact on the younger, working-age workforce
Historically viewed as a condition primarily affecting older populations, cancer is increasingly impacting younger adults. Data from Marsh McLennan Agency’s 2026 Employee Health & Benefits Trends show that between 2018 and 2024, cancer incidence among individuals ages 20–29 nearly doubled, rising from 3.8 to 6.7 cases per 1,000.
For employers, this shift shows up in real and immediate ways. According to the American Cancer Society, cancer is increasingly diagnosed during peak earning and career-building years—when employees are managing careers, families, and caregiving responsibilities, not preparing for retirement. Rising cancer incidence among younger adults is driven primarily by breast and colorectal cancers, with younger women disproportionately affected by breast and thyroid cancers and younger men seeing increases in colorectal, testicular, kidney cancers, and leukemia. Screening guidelines have been lowered for several major cancers, including breast and colorectal cancer, reflecting these changing demographics.
How employers are responding: mitigating risk and cost
Focus on early detection and prevention
As noted in the American Cancer Society’s Cancer Facts & Figures 2025, early detection remains one of the most effective ways to improve cancer survival and reduce the burden of treatment.
According to Mercer’s 2024 National Survey of Employer-Sponsored Health Plans, only 8% of employers report having a comprehensive cancer strategy in place to address quality of care and provide robust support. That percentage is expected to grow as cancer increases in both cost and business impact. For those with strategies in place, specialized case management and/or navigation support are the most common. These strategies better support members seeking complex care and often drive a return on investment as a result.
How Marsh McLennan Agency can help
Advanced screening and navigation programs can increase screening participation through convenience and access. Mercer reports that only 11% of employers with a cancer strategy in place have adopted proactive approaches that help identify hidden cancer risks earlier—when treatment is typically less intensive and outcomes are more favorable.
These solutions help address one of the most common barriers to screening: fear of results and uncertainty about next steps. Employers that succeed in this space typically see higher screening participation, earlier-stage diagnoses, improved employee experience, and reduced long-term cost volatility.
MMA works collaboratively with employers to help interpret claims trends, such as cancer claims trends, into actionable, sustainable strategies by:
- Tracking, reporting, and interpreting claims and population health data
- Evaluating and integrating screening and navigation solutions
- Aligning cancer initiatives with medical, pharmacy, and wellbeing programs
- Assessing the effectiveness and integration of resources across the cancer strategy mosaic, including professional medical opinions, Centers of Excellence, caregiver support, and personalized communication
- Supporting governance, communication, and measurement
By embedding cancer prevention and early detection into a broader population health strategy, employers who act early may improve outcomes while managing long-term cost exposure.
Cancer will continue to be a defining challenge for employer-sponsored health plans—not because it is new, but because it is changing. Employers that recognize this shift and act earlier are better positioned to manage cost volatility, support their workforce, and build more resilient benefits strategies.
