Dental
Insurance and Oral Cancer Survivorship
New Research Provides Evidence of the Benefits of Screening Provided by Plans

by Patrice P. Bergman, CEBS

Group and individual dental insurance plans are increasingly including oral cancer screening benefits to aid in the early detection of the sixth most common cancer in the United States. And here’s an interesting fact worth noting: new research shows a link between survival rates and whether a patient has insurance.

Both of these developments give producers more opportunities to talk with clients about the added value that dental plans present in improving not just oral health, but also overall health.

Roughly 40,000 Americans are diagnosed with oral cancer every year and one dies of the disease every hour of every day, according to the American Dental Association. Yet, oral cancer can be cured if found early. If detected at the pre-cancerous stage, oral cancer can often be prevented altogether. The Oral Cancer Foundation reports that oral cancer is 90% curable when found in its early state. The survival rate drops to 57% when diagnosed in later stages.

Dental professionals are in a unique position to detect oral cancer in its early phases since many people visit their dentist more often than their primary care physician. During an annual oral exam, dentists routinely perform thorough examinations of the mouth. While about 50% of people see their dentist at least annually, people with dental benefits that cover two or more annual visits see their dentists even more frequently.

The way to stop oral cancer in its tracks is through early detection. Oral cancer screening is a small, but very important part of the dental oral exam and it’s crucial to preventing more costly medical procedures.

Tapping into Technology

Today, the advanced technology being used in annual dental exams is helping improve the oral cancer survival rate even more. New screening devices can detect the most commonly diagnosed forms of oral cancer and cancerous conditions before they are visible to the eye. Using dyes, rinses, and chemiluminescent and fluorescence light technology, dentists can pick up clues to symptoms of oral infections and markers of serious health issues, such as mucosal abnormalities as well as pre-malignant and malignant lesions.

There are many effective methods for early detection of oral cancer, but it’s worth noting that some carriers have only agreed to cover certain kinds of oral cancer screening methods. Brokers who are presenting dental plans with oral cancer screening benefits should consider the value of the plans including any coverage limitations on screening with a particular method or brand name.

Improving the Odds

Private insurance doesn’t just make it easier to visit the dentist more frequently; it also seems to actually improve the odds of surviving oral cancer, according to research published in the journal, Cancer.

Patients with private insurance had better survival rates than patients with no insurance, those on Medicaid, and those on Medicare disability, according to a study of more than 1,200 patients treated at the Pittsburgh Medical Center between 1998 and 2007 with cancers of the head or neck, including mouth and salivary glands.

The poorer survival seemed to be partly explained by later diagnosis. People without private insurance generally had more advanced cancer by the time they saw a doctor. -Researchers hypothesize that these patients are less likely to get screened for head and neck cancers or may have to delay treatment after a diagnosis.

Oral Cancers on the Rise

In addition to checking oral health, a dental exam is important to health management because of the evidence connecting periodontal disease to cardiovascular disease, stroke, and pre-term and low birth weight babies. Once a person is identified for being at risk, they can enroll in a disease management program to improve their health, which also helps the employers control healthcare costs.

As with most cancers, age is the primary risk factor for oral cancer. With the graying of the workforce and the increasing proportion of older workers, early detection and treatment may have a significant effect on employers’ cost of healthcare, since cancer treatment would be covered under the medical plan.

Over the past three years oral cancer diagnoses have increased. Although men face twice the risk as women, incidents have also increased among women, young people, and even non-smokers.
Treatment Costs Increase

An oral cancer-screening test using the latest technology can cost a patient $35 to $65 without the dental coverage. That may not seem like much, but it’s often a big enough financial impediment to discourage people from getting the test, particularly when other services aren’t covered by co-payments.

The cost of treatment is far higher, of course. Oral cancer is one of the most expensive cancers to treat; the cost of treating an advanced case averages about $200,000, according to Dr. David Wong, director of UCLA’s Dental Research Institute.

Cancer drug therapy costs continue to rise. Oncology drugs can cost $4,000 per patient per month. Emerging therapies, new treatment options, and an aging population are driving a projected 12% to 15% year-over-year growth in oncology drug costs through 2012, according to IMS Health Inc.
A combination of medical and dental insurance can have a big impact on an individual’s cost of healthcare.

Oral Health Pays Dividends

Many employers recognize that investing in oral health pays big dividends in overall health, well-being, productivity, and retention. Approximately 62% of employers view dental health coverage as essential to their benefit packages, according to a 2008 study by the National Association of Dental Plans. (NADP). The NADP reports growing awareness among employers about the connection between oral and overall health. Employers that have included dental coverage say that their workers’ attitudes and behaviors about their dental health and overall health have improved.
Since poor oral health can add to employees’ time away from work, the loss of productivity can affect the company’s bottom line. More than 164 million work hours are lost each year because of dental problems, according to the American Dental Education Association.
Producers can take advantage of this information by encouraging clients to polish up their employees’ understanding of their dental benefits through employee newsletters, intranet or bulletin board postings, benefit education sessions, and other communication vehicles. These outreach efforts can increase their appreciation of their employer’s commitment to providing a strong benefit package.

In Summary

Given how new technology can raise cancer survival rates and reduce healthcare costs, producers should include oral cancer screening as a benefit differentiator when evaluating and recommending group dental plans.
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Patrice P. Bergman, CEBS, is the director of sales and product strategy for Specialty Benefits at Blue Shield of California, a non-profit health plan dedicated to providing Californians with access to high quality care at a reasonable cost . Blue Shield of California is one of the largest provider networks. Ms. Bergman can be contacted at patrice.bergman@blueshieldca.com. For more information, visit www.blueshieldca.com.