Cancer has always been one of the most demanding and costly challenges in employer-sponsored healthcare, but the pace of change today is unlike anything I have seen in my 30+ years in this field. What once felt like a steady and predictable part of a benefits strategy is now a moving target. Incidence is rising, therapies are more advanced and more expensive, and employees often feel overwhelmed long before treatment even begins.

It is no surprise that cancer remains the top driver of employer healthcare costs for the fourth year in a row. The Business Group on Health reports that 88% of employers say it is their most significant contributor to spend. That reflects what we see across AccessHope’s partners: Younger employees are being diagnosed more often, treatment decisions are more complex, and the cost of new therapies continues to climb.

A new cancer landscape for employers

Heading into 2026, employers face a set of realities they cannot ignore.

Cancer incidence among younger adults is rising in ways that challenge longstanding assumptions. The American Cancer Society reports that cancer rates in women under 50 are now 82% higher than in men, which represents a significant shift from two decades ago. Early-onset colorectal cancer is increasing among adults under 65, and cervical cancer rates are growing for women ages 30 to 44. These trends mean more employees are confronting cancer earlier in their careers, creating long-term implications for cost, productivity, and wellbeing.

Oncology costs are also increasing rapidly. The United States spent $99 billion on anticancer therapies in 2023, according to a Nature Reviews Clinical Oncology study. Ninety-five percent of therapies launched that year cost more than $100,000 annually. Projections show spending rising to $180 billion by 2028. These innovations can be life-changing, but they also raise the stakes for ensuring employees receive the right therapy at the right time.

Another persistent issue is the wide variation in how cancer is diagnosed and treated. More than half of Americans receive cancer care in community practices, where clinicians work tirelessly but often struggle to keep pace with constantly evolving standards. A Johnson & Johnson survey found that 73% of oncologists feel overwhelmed by the speed of treatment innovation, and 70% struggle to stay current with guidelines.

For employees, that complexity often translates into confusion, delays, and fragmented decisions. A cancer diagnosis can derail anyone’s ability to manage appointments, understand treatment options, or navigate insurance requirements. Even high-performing employees need help finding the right care path.

Where employers can make a measurable impact

The good news is that employers have meaningful levers that improve access, reduce waste, and support employees through a challenging time. Here are five actions employers can take: 

1. Invest in precision diagnostics

Genomic and biomarker testing help determine the most effective therapy from the start, including targeted treatments, immunotherapies, or antibody-drug conjugates. Without these diagnostics, employees may receive less effective treatments, which increases costs and toxicity. Expanding coverage for precision medicine is clinically sound and financially responsible.

2. Strengthen navigation and care coordination

Cancer is not something employees should have to navigate alone. Oncology nurse navigators help reduce delays, avoid duplicative testing, streamline appointments, and ensure employees understand their diagnosis and treatment plan. Navigation also plays a key role in supporting underserved populations that face greater barriers to timely care.

3. Prioritize screening and prevention

As cancer affects younger adults more often, screening policies need to reflect today’s realities. Early detection consistently lowers the total cost of care and improves outcomes. Employers that update screening guidelines, encourage preventive care, and support programs that address tobacco use, alcohol consumption, and nutrition can help identify cancers earlier, when treatment is more effective and less expensive.

4. Expand access to subspecialist expertise

Most employees will not seek expert second opinions on their own, even though the impact can be significant. Research from AccessHope shows that subspecialist reviews recommend changes to cancer treatment in 52% of cases and changes to supportive care in more than one-third of cases. Incorporating this expertise into benefit design ensures employees receive the right treatment path early on.

5. Support survivors beyond treatment

Survivorship is a long stage of the cancer experience and requires thoughtful benefit design. The American Cancer Society estimates there are 18.6 million cancer survivors in the United States today, with the number expected to exceed 22 million by 2035. Survivors often return to work with lingering symptoms, mental health needs, and ongoing monitoring requirements. Flexible return-to-work options, mental health support, and structured survivorship programs help employees reintegrate with confidence and stability.

Building benefits that match modern cancer care

Cancer care is evolving faster than many traditional benefits programs can adapt. To stay ahead, employers must modernize their approach and ensure their benefits reflect how cancer is diagnosed and treated today.

By focusing on precision diagnostics, strong navigation, proactive prevention, subspecialist expertise, and survivorship support, employers can build a benefits package that meets the needs of a modern workforce. Those who take the lead will not only manage rising costs more effectively but also ensure every employee receives the proper diagnosis, the right expertise, and the right treatment path when it matters most.