Waiting period from diagnosis for mortgage insurance issued to cancer survivors

The Massart (J Cancer Policy 15:70–71, 2018) testimonial illustrates the difficulties faced by patients having survived cancer to access mortgage insurance securing home loan. Data collected by national registries nevertheless suggest that excess mortality due to some types of cancer becomes moderate or even negligible after some waiting period. In relation to the insurance laws passed in France and more recently in Belgium creating a right to be forgotten for cancer survivors, the present study aims to determine the waiting period after which standard premium rates become applicable. Compared to the French and Belgian laws, a waiting period starting at diagnosis (as recorded in national databases) is favored over a waiting period starting at the end of the therapeutic treatment protocol. This aims to avoid disputes when a claim is filed. Since diagnosis is often recorded in the official registry database, as is the case for the Belgian Cancer Registry, its date is reliable and unquestionable in case of claim. Based on 28,994 melanoma and thyroid cancer cases recorded by the Belgian Cancer Registry, the length of the waiting period is assessed with the help of widely-accepted tools from biostatistics, including relative survival models and time-to-cure indicators. It turns out for instance that a waiting period of 4 years after diagnosis is enough for 30-year-old thyroid cancer patients. This appears to be similar to the 3-year period starting at the end of treatment protocol according to the Belgian law in such a case.