New data show South African cancer survival rates improving dramatically. However, access gaps, recurrence risks, and the costs of innovation mean the battle is far from won.
For the first time in a generation, the arc of cancer in South Africa is bending toward survival.
Discovery Health’s HealthTrend2026 report, released this week, reveals that life expectancy for members enrolled on the scheme’s oncology programme has improved by 7.1 years over the past 15 years, while mortality among cancer patients has declined by 48%.
The number of members living with cancer has increased by 120% since 2015, not because more people are getting sick, but because more people are surviving.
Yet as Novartis South Africa’s Dr Renata Maharaj noted on National Cancer Survivors Day earlier this month, surviving cancer is not the end of the story.
“The reality is that to improve cancer outcomes, healthcare must be people-centred and sensitive to patients’ perceptions, lived realities and information needs.”
For many South Africans, the journey from diagnosis through treatment and into survivorship is shaped as much by what they can access as by what medicine can offer.
The gap between diagnosis and living
The Discovery Health data tells a story of genuine progress within the insured population.
Breast cancer, which accounts for 26% of all cancer patients on the scheme, now has a five-year survival rate of 96% when detected at an early stage, compared to just 61% for a metastatic diagnosis.
Cancer incidence has risen by 69% since 2015, while prevalence has risen by 120%, a widening gap that reflects a system in which more people are being diagnosed and living longer with the disease.
The recurrence risk no one talks about
One of the most under-discussed dimensions of cancer survivorship is the ongoing risk of recurrence once treatment has concluded.
Dr Maharaj, Head of Medical Affairs, has been vocal on this point in the lead-up to Cancer Survivors Day.
Many patients, she noted, leave treatment believing the cancer journey is over.
“Patients often believe that once treatment ends, the cancer journey is over, but clinically, that’s not the case,” she said. “The risk of recurrence is real, and without regular check-ups, surveillance, and in some cases ongoing therapy, cancer can return undetected until it is more advanced and harder to treat.”
For breast cancer specifically, the recurrence risk sits at approximately 30%, with most recurrences occurring within two to five years of completing treatment.
Maharaj explained the biological mechanism behind this risk in accessible terms.
“Cancer is like a moving target, making it hard for any treatment to capture and kill all cancerous cells. Surgery to remove a cancerous tumour may miss some cells because they were too small to detect. Cancer constantly evolves as cells mutate and change.”
The implication is that survivorship is not a destination but an ongoing clinical commitment, one that requires structured follow-up, long-term monitoring and, in some cases, continued therapy.
The power and inequality of early detection
Both the HealthTrend2026 data and the Novartis-backed perspective converge on a single, evidence-backed conclusion: the stage at which cancer is detected is among the strongest determinants of what follows.
The Discovery Health report found that regular screening increases the likelihood of early-stage diagnosis by 19% and is associated with a 67% relative reduction in mortality risk.
The average annual cost of treating a metastatic cancer diagnosis is R131,000. This is 2.8 times the cost of an early-stage diagnosis.
Oncologist Dr Keo Tabane was direct about what this means in practice.
“From a clinical perspective, the difference between early and late diagnosis is often the difference between life and death. We know that when patients are diagnosed early and have consistent access to treatment and follow-up care, outcomes improve significantly.
“But too many patients in South Africa enter the system late, when treatment options are more limited and less effective.”
Novartis’s Sanjay Govender, Interim Head of Value and Access, framed the access question as fundamentally one of equity.
“Access to care is one of the most significant determinants of cancer outcomes. When patients can access the right treatment at the right time and continue that care without interruption, their chances of survival improve dramatically. Addressing barriers to access is not just a healthcare issue; it’s a matter of equity.”
Treatment innovation
The HealthTrend2026 report documents a remarkable shift in how cancer is being treated within the insured population.
In 2009, standard chemotherapy was used in 63% of cases and accounted for 42% of oncology spend. By 2025, it represented just 42% of cases and 12% of spend, with biological therapies, immunotherapies and targeted agents accounting for an increasing share of both treatment and cost.
Discovery Health CEO Dr Ronald Whelan noted the trajectory with pride.
“Earlier detection and better therapies are improving cancer outcomes in a way we have not seen before. The focus is to continue advancing cancer care while ensuring long-term sustainability of access.”
However, the report is candid about the cost implications. It showed oncology treatment inflation has exceeded 10% annually over the past decade, more than doubling to 26% for newer innovative therapies. In the last five years alone, oncology costs have risen by 48% per member per month.
Tabane acknowledged the tension between innovation and access.
“Patients who are insured are more likely to have innovative drugs, novel drugs, targeted treatment, immunotherapy, and so forth. And because of the cost, naturally those kinds of innovations are not freely available in the public sector.”
She also noted disparities in access to clinical trials, with far more trial units available in the private sector than in public facilities.
Continuity of care
Beyond the initial treatment phase, both Novartis’s research and the Discovery Health data highlight continuity of care as a critical but frequently neglected determinant of long-term outcomes.
Cancer is increasingly being managed as a chronic condition, requiring ongoing monitoring, side-effect management and sustained access to medication and support.
Maharaj cited evidence showing that patients who receive uninterrupted, guideline-consistent care have markedly better survival outcomes.
“Improving survival rates in South Africa will require a more integrated, patient-centred approach, one that prioritises early detection, strengthens healthcare systems, and ensures equitable access to care across the entire patient journey,” she said.
Discovery Health’s oncology benefit covers 93% of treatment costs, with more than 108 000 members enrolled in the scheme’s oncology programme.
Tabane described the benefit as genuinely comprehensive. But she was equally clear that this level of support remains unavailable to the majority of South Africans, who rely on a public health system stretched beyond its capacity to deliver guideline-consistent cancer care.
