Prostate Cancer Insurability: Population Identification Within the Insurability Corridor and the Right to be...

Prostate cancer is one of the most common cancers, with an approximate global annual incidence of 1.5 million men and nearly 400,000 deaths. Treatment options include surgical resection, radiotherapy, and high-intensity focused ultrasounds, often combined with hormone deprivation therapy. Insurability of prostate cancer patients is evaluated based on tumor severity using the AJCC and TNM classifications, along with PSA levels and Gleason Scores. To control the risk, life insurers use medical selection, albeit many individuals may be excluded from coverage. Regulations, such as France's "Right to Be Forgotten," allow standard rate acceptance for certain prostate cancer survivors under specific conditions.

By matching patient data from the SEER database with mortality tables, we established a Cox survival prostate cancer model for patients sharing similar long-term survival risk and compared it with that of the general population.

By investigating risks in populations of various age ranges, we defined groups with variable survival risk. To distinguish insurable from uninsurable, we have defined a so-called "acceptance corridor," which delimits the boundary within the expected normal range of survival for a group of age and the highest acceptable premium. This corridor is delimited with an upper boundary depicted where the risk is equal to the standard population and a lower boundary where the risk of death is higher than that of the normal population or where the risk overpasses the maximum acceptable premium of 250%.

In this paper, we have revisited the risk of individuals with a history of prostate cancer and have provided estimates of risk belonging within an acceptance corridor of insurability, broadening options for standard rate. This method may be further used to evaluate the impacts of regulatory guidelines, rules, and regulations, such as the right to be forgotten, to cancer patient populations.