Right to be forgotten: KCE proposes to shorten waiting time
As a survivor, it is often difficult to take out an (outstanding balance) insurance policy. From a medical point of view, you may be cured, but the insurer probably thinks otherwise. The government has the important task of making (outstanding balance) insurance policies accessible to people with a history of cancer.
Since the 1st of February 2020, survivors have the 'right to be forgotten'. This means that the insurer may not refuse a survivor nor charge a higher premium if the survivor has been in full remission for at least 10 years.
The Royal Decree that entered into force on the 1st of April 2020 goes even further. It specifies certain types of cancer for which the 10-year period is shortened. For some types of breast cancer, the term is even reduced to one year. Insurers are not allowed to refuse these patients and a higher premium is either prohibited or limited by a reference grid.
The Belgian Health Care Knowledge Centre (KCE) must regularly re-evaluate the reference grids for the right to be forgotten. Based on a thorough analysis of the survival curves for early-stage breast cancer, KCE researchers made proposals to shorten the current waiting time, which could potentially affect an average of one in two people affected by breast cancer.
Below, we translate the most important information from their press release of the 5th of April 2022*:
A first report on breast cancer
The first report on the right to be forgotten examined breast cancer in situ or early-stage invasive breast cancer (carcinoma). Cancer in situ refers to a tumour that is confined to the tissue in which it originated.
In contrast, an invasive cancer has cells that invade surrounding tissue. However, in the early operable stages (stages I or II) considered here, the lymph nodes are not appreciably affected and there is no metastasis.
In the case of breast cancer, the reference grid currently provides for a waiting period of one year after completion of treatment for cancer in situ and ten years for all other stages. The question is whether these waiting times are excessive for small and localised tumours, especially as they represent a large proportion of diagnosed – and successfully treated – breast cancers today.
A meticulous task
KCE researchers worked closely with the Belgian Cancer Registry, which collects and analyses data on all cancers diagnosed in Belgium. The registry now covers at least 98 % of all cancer diagnoses, and more than 99 % of all breast cancers.
Out of a total of 132,425 breast cancer diagnoses (since 2007) in the Cancer Registry database, statistical analyses were performed on the survival data of 93,368 individuals, namely 10,452 with cancer in situ and 82,916 with stage I or II carcinomas.
Researchers chose as the most relevant survival indicator (in the context of the right to be forgotten) the 'statistical cure point', i.e. the shortest time after diagnosis after which the mortality risk of people with cancer becomes comparable to that of the general population of the same sex and the same age group. It is important to emphasise that this is a statistical concept that applies to all patients and not to any particular individual. It is quite possible that a patient will be considered ‘clinically cured’ (in remission) before the statistical cure point is reached.
Towards a shortened waiting time for many women?
Based on 10,452 cases of cancer in situ, no excess mortality was found up to 14 years after diagnosis. Therefore, the researchers propose that there should no longer be a waiting period for people with this type of cancer.
For small (called T0 or T1) and early (stage I) invasive carcinomas, survival curves approximate those of the general population from 1 year and over the next 10 years. The KCE therefore proposes to consider a waiting period of 1 year instead of the current 10 years.
In total, therefore, this revision of the reference grids could potentially affect an average of one in two women diagnosed with breast cancer, based on the Cancer Registry figures. In addition, the KCE proposes that the waiting period be calculated from the date of diagnosis rather than from the date of completion of treatment, as is currently the case. The date on which treatment is completed is difficult to establish, while the date of diagnosis is usually very accurate.
What is going to happen now?
In accordance with the law, the KCE has forwarded its proposals to the Monitoring Office for Debt Balance Insurance Tariffs, which will then communicate them, accompanied by its own advice, to the competent political authorities (State Secretary for Consumer Protection, Minister of Social Affairs and Minister of Economic Affairs). The latter will ultimately decide whether or not to implement the changes.
Read the full KCE press release dated April the 5th, 2022* (NL)
Read the full KCE press release dated April the 5th, 2022* (FR)
Read more about the right to be forgotten for outstanding balance insurance policies (EN)
Read more about the right to be forgotten for guaranteed income insurance (EN)