According to the American Cancer Society, excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the U.S. Overall, the lifetime risk of developing colorectal cancer is about 1 in 21 for men and 1 in 23 for women.
Colorectal cancer is the second leading cause of cancer-related mortality in the U.S. when considering tumors that affect both men and women; however, incidence and mortality from colorectal cancer has decreased overall within the past two decades due to screening, early detection and intervention, and improved treatments.
What Is Colorectal Cancer?
Colorectal cancer is a cancer that starts in the colon or the rectum. These cancers can also be named colon cancer or rectal cancer, depending on where they start. Colon cancer and rectal cancer are often grouped together because they have many features in common. Most colorectal cancer arises slowly from a polyp over 7 to 15 years.
What Causes Colorectal Cancer?
A number of risk factors have been identified for colorectal cancer, including a personal or family history of adenomatous colorectal polyps or colorectal cancer, including hereditary colorectal cancer syndromes; and history of inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis. These factors are some of which individuals have no power over; however, there are colorectal cancer risk factors that are lifestyle-related.
Colorectal cancer risk factors you can change:
- Being overweight or obese
- Physical inactivity
- Certain types of diet
- Heavy alcohol use
Having any one of these risk factors does not mean that you will get colorectal cancer, and some people may get colorectal cancer even if they don’t have any of these factors. There is no sure way to prevent colorectal cancer, but getting regular health screenings is one of the most powerful weapons against diseases.
Treating Colorectal Cancer
There are several ways to treat colorectal cancer, depending on its type and stage.
- Targeted therapy
Oftentimes combining treatment methods may be the best approach. Regular follow-up after treatment for colorectal cancer is important and can include periodic physical examinations, colonoscopy, imaging of the abdomen, pelvis, and chest, such as with CT scanning, and measurement of levels of a tumor marker in the blood cell called Carcineombryonic antigen, or CEA.
Underwriting Colorectal Cancer
Life insurance underwriters look at the overall picture of an applicant to determine risk. Their ratings will depend on the stage of colorectal cancer and time since the end of treatment. Staging of colorectal cancer is based on invasion of the four layers of the colon. The four layers of the colon are: muscosa, submucosa, muscularis propria, and serosa. The prognosis worsens as deeper layers of the colon wall are invaded. The preferred staging system for colorectal cancer is the TNM system.
- T describes the size of the primary tumor and whether it has invaded nearby tissue,
- N describes nearby lymph nodes that are involved,
- M describes distant metastasis, whether cancer has spread.
The table below describes what constitutes a certain stage classification.
|0||Tis, N0, M0||In-situ, tumor confined to mucosa|
|1||T1, N0, M0||Tumor through the mucosa into submucosa|
|1||T2, N0, M0||Tumor through submucosa in muscularis propria|
|IIA||T3, N0, M0||Tumor through muscularis propria and into subserosa but not into neighboring tissues|
|IIB||T4, N0, M0||Tumor into nearby tissues or organs, but nodes remain negative|
T1, N1, M0
T2, N1, M0
|T1 or T2 plus 1-3 nodes positive|
T3, N1, M0
T4, N1, M0
|T3 or T4 plus 1-3 nodes positive|
|IV||M1||Spread to distant sites such as liver, lung, peritoneum, ovary, etc.|
Tis = carcinoma in situ; T1-T4 = size and/or extension of the primary tumor
N0 = tumor cells absent from nearby lymph nodes; N1 = metastasis present at nearby lymph nodes
M0 = no distant metastasis; M1 = metastasis to distant organs beyond nearby lymph nodes
Not all insurance companies underwrite the same, but if an applicant had been diagnosed with Stage III cancer with more than two lymph nodes positive or Stage IV, they are typically going to be declined for life insurance. A Stage III diagnosis with only two or fewer positive lymph nodes will likely be approved, but table rated and may include a flat extra for a certain number of years. A Stage I or Stage II diagnosis is likely to be a Table Rating of B, C, or D. Stage 0, or a confined tumor, can get a “normal” classification without being table rated.
The “normal” risk classes are as follows (starting with the best offer possible): Preferred Plus, Preferred, Standard Plus, and Standard. If an applicant does not fit into one of these categories based on their risk assessment, a life insurance company will either offer them a Table Rating, add a Flat Extra, or they could be declined.
When an insurance company classifies an applicant with a table rating, this typically means the applicant will have to pay the standard rates plus a certain percentage. Depending on the insurance carrier, an alphabetical or numerical table is used.
|Table Rating (alphabetical)||Table Rating (numerical)||Pricing|
|A||1||Standard + 25%|
|B||2||Standard + 50%|
|C||3||Standard + 75%|
|D||4||Standard + 100%|
|E||5||Standard + 125%|
|F||6||Standard + 150%|
|G||7||Standard + 175%|
|H||8||Standard + 200%|
|I||9||Standard + 225%|
|J||10||Standard + 250%|
A carrier will sometimes add a flat extra to cushion the risk they are taking in approving an applicant. The flat extra can last the entire life of the policy or just a few years spending on the case. Let’s take a look at a couple examples of individuals with history of colorectal cancer applying for life insurance to get a better grasp on underwriting and pricing.
Elizabeth is a 70-year-old applicant with a history of Grade I (cancer cells that resemble normal cells) localized adenocarcinoma of the colon that was treated with surgery ten years ago. There has been regular follow up with no evidence of recurrence.
Elizabeth could be approved for Standard Plus.
James is a 65-year-old applicant with a history of Grade IV (cancer cells do not appear normal at all) adenocarcinoma of the colon that invaded two local lymph nodes that was treated with surgery and chemotherapy. There has been regular follow up with no evidence of recurrence since the completion of treatment just over seven years ago.
James could be approved for Standard but will have to pay a flat extra of $15 per $1000 of coverage for three years.
That means, for example, if he purchased $200,000 worth of coverage, he would be required to pay an extra $3000 (15 x 200) per year for three years. After year three, his payment would drop to the normal Standard premium amount.
Betsy is a 50-year-old applicant with a history of adenocarcinoma of the colon metastatic to the liver who has not seen a doctor since completion of surgery and chemotherapy two years ago.
Betsy would be declined.
A benefit to working with Quotacy is that we work with multiple A-rated life insurance companies. We have the ability to shop cases around to different companies to try our best to get an applicant approved.
We have the ability to shop cases around to different companies to try our best to get an applicant approved.
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If you have any questions regarding underwriting colorectal cancer, feel free to contact us or jot us a message in the Comment section below. If you are looking to get an idea on the cost of life insurance if you have colorectal cancer, it costs nothing to run a quote and apply online. You will have a dedicated Quotacy agent shop your case with our top-rated life insurance companies to ensure you receive the best possible price.
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