According to new healthcare quality data, a significant number of South African residents who have health insurance policies are not utilizing the benefits available to them for cancer screening.
The latest Health Quality Assessment (HQA) report, based on 2025 data covering 7.38 million medical plan beneficiaries, showed that colorectal and breast cancer screening rates remain low, despite gradual improvements in some indicators.
Over 85% of beneficiaries aged 50 to 75 have not undergone colorectal cancer screening in the last five years. Nevertheless, HQA noted that the proportion of beneficiaries undergoing colonoscopy has steadily increased since 2019 and continued to rise in 2025. The number of fecal occult blood tests also increased during the year, although the overall coverage rate remained low.
Progress
HQA explains the increase in testing due to heightened awareness and participation from plan members, recommendations from healthcare professionals, and continuous efforts by medical plans to promote accessible benefits.
Breast cancer screening shows a similar trend. In 2025, among female beneficiaries aged 40 to 75, 23.5% had at least one mammogram in the last two years, compared to 64% who did not have a mammogram in the previous five years.
Some successes have been achieved: HQA data indicates that the proportion of eligible women who have not had a mammogram in five years has steadily decreased since 2019. The report also identified a significant disparity between different medical plans, suggesting that some plans achieve higher screening rates.
Improved Care
HQA CEO Louis Botha emphasized that having access to screening benefits is only the first step toward improving healthcare. He stated: 'Providing preventive and screening benefits is an important first step, but these benefits can contribute to better health outcomes only when people use them.'
These screening figures contrast with some improvements recorded in chronic disease monitoring. For instance, diabetes treatment has shown steady improvement over the HQA measurement period. In 2025, 75.6% of beneficiaries registered for chronic diabetes medication benefits underwent at least one HbA1c test within the year.
This test is used to monitor average blood glucose levels over approximately three months. The proportion receiving the recommended minimum of two HbA1c tests per year has also steadily increased since 2021, reaching 42% in 2025. The HQA survey covers over 200 healthcare quality indicators and represents more than 84% of the insured population in South Africa's medical plans.
Applying Lessons
HQA notes that the diabetes data confirms the value of tracking healthcare quality over time. Botha commented: 'It allows us to see that improvement is possible, and then ask what contributed to that progress and how those lessons can be applied in other areas.'
Improvements were also observed in other areas of preventive and chronic care. Since 2019, cholesterol screening among certain diabetic beneficiaries has increased by almost 30 percentage points, and screening among patients with coronary heart disease has risen by almost 20 percentage points.
However, a broader HQA analysis showed that preventive care remains uneven. Influenza vaccination among beneficiaries aged 65 and older dropped from 21.2% in 2024 to 17.5% in 2025. HIV viral load testing remained above 85% among beneficiaries regularly receiving antiretroviral drugs, but was still below the target of 95%.
More C-sections
Furthermore, the report found that in 2025, 76% of births in participating plans were delivered via Caesarean section, and this figure remained persistently high throughout the measurement period.
HQA results cover over 200 healthcare quality indicators and represent more than 84% of the insured population in South Africa's medical plans. Botha noted that the goal of tracking these indicators was to identify areas where healthcare is improving and where additional attention is needed. He added: 'Where the results show progress, we need to understand what is working. Where they reveal gaps, they give us the opportunity to act.'