They have medical cover, so why are so many South Africans skipping cancer screening?

Despite holding medical scheme coverage, a significant portion of South Africans are failing to take advantage of cancer screening benefits. The Health Quality Assessment (HQA) 2025 report, which analyzed data from 7.38 million medical scheme beneficiaries, revealed that over 85% of individuals aged 50 to 75 had not undergone colorectal cancer screening within the past five years.

Similarly, the faecal occult blood test screening, while showing a slight increase, still remained low across the board. Breast cancer screening among women aged 40 to 75 showed that only 23.5% had received a mammogram in the past two years, while 64% had not had a mammogram within the past five years. However, the report highlighted that progress has been made, with the percentage of women who had not had a mammogram over five years declining since 2019.

Chief Executive of HQA, Louis Botha, emphasized that a screening benefit is merely the initial step towards enhanced medical care. "Providing screening and preventive benefits is a crucial starting point, but those benefits can only lead to better health outcomes when people utilize them." The data also indicated that the level of screening varies among medical schemes, with some schemes achieving higher screening rates compared to others.

In contrast to the cancer screening data, improvements in chronic disease monitoring were evident. For instance, 75.6% of beneficiaries registered for diabetes care received at least one HbA1c test in 2025, a test used to monitor average blood glucose levels over approximately three months. The proportion receiving the recommended minimum of two HbA1c tests per year also increased from 2021 to 42% in 2025.

These figures underscore the potential benefits of tracking healthcare quality over time, as shown by the improvement in diabetes care.