Cancer in situ means that epithelial malignant tumor is confined to skin or mucosa and has not invaded the surrounding tissues through the basement membrane of skin or submucosa. Mei Changlin, chief physician of Shanghai Changzheng Hospital, explained that cancer in situ is the earliest stage of cancer, and every kind of cancer begins with cancer in situ. This cancer has not metastasized, so the cure rate is relatively high. For example, the cure rate of colon cancer in situ can reach 80% to 90%, and the cure rate of liver cancer in situ is not less than 50%. Therefore, the World Health Organization did not include it in the Code of Malignant Tumors. Li Wenqiang, a senior life insurance consultant in Beijing, believes that the definition of major diseases in insurance should generally conform to the principles of "three highs and one low", that is, high morbidity, high mortality, high expenses and low cure rate. The reason why cancer in situ is excluded is that cancer in situ does not meet the standard of "three highs and one low" and has not yet developed into a cancer in a strict sense. Tumors with precancerous lesions do not belong to claims for cancer diagnosis in critical illness insurance. According to the claim adjuster of an insurance company, most insurance companies have always regarded cancer in situ as the exclusion liability of critical illness insurance. Because cancer in situ is actually a small problem, the medical expenses spent are generally several thousand yuan. Moreover, the definition of cancer in situ is more professional, and misunderstandings often occur when making claims, and insurance companies are not willing to make trouble. It is understood that the reason why the regulatory authorities list cancer in situ as an exclusion liability is also to reduce the rate of critical illness insurance. For each additional disease in critical illness insurance, the rate will generally increase accordingly. Experts say that cancer in situ has a high cure rate and low cost, which is affordable for ordinary consumers. The significance of critical illness insurance lies in timely payment of insurance benefits to protect the financial situation of the insured during illness. Therefore, in addition to the characteristics of "three highs and one low", the treatment cycle of serious diseases included in the scope of protection is also relatively long. If cancer in situ is classified as a serious disease, it will increase the psychological burden of consumers. However, the incidence of carcinoma in situ in cervix, breast and prostate is still high, and now the incidence of gynecological diseases and male prostate diseases is gradually increasing. Therefore, some insurance companies have included cancer in situ in the critical illness insurance. * * * * * * * * * * * * * To understand this problem, we must understand the relationship among carcinoma in situ, primary carcinoma, invasive carcinoma and carcinoma. Cancer in situ is an early cancer, which generally refers to atypical hyperplasia in mucosal epithelium or skin epidermis, often involving the whole epithelium, but not infiltrating submucosa or dermis. If the cancer tissue continues to develop, it may evolve into invasive cancer. It is generally believed that cancer in situ can be cured if it can be actively treated. It rarely brings pain to the patient's body and mind, and major diseases are ruled out. Most cancers in situ occur in cervix, skin, bronchus, stomach, prostate and breast. Common carcinoma in situ includes squamous cell carcinoma of cervix, intraductal carcinoma of breast, peget's disease of breast, bowen's disease of skin, transitional cell carcinoma of bladder in situ, squamous cell carcinoma of larynx in situ, etc. Primary cancer refers to the canceration of normal cells in normal tissues under the action of various carcinogenic factors. Primary cancer may occur in all tissues and organs except nails and hair. If cancer cells transfer from the primary site to other parts of the body through blood and lymph, it is called metastatic cancer. Primary cancer includes all stages of cancer development, that is, invasive cancer in situ, spreading and transferring to the whole body. Only carcinoma in situ is not eligible for compensation. Invasive cancer; Cancer cells break through the basement membrane and develop into invasive cancer. Invasive cancer is eligible for compensation regardless of metastasis. Most of the cancers found in clinic are invasive cancers, and there are few pathological reports of carcinoma in situ. There are two misunderstandings in the payment of malignant tumor by critical illness insurance; One is to understand cancer in situ as cancer that has not yet metastasized, and think that insurance companies should compensate. When the insurance company refuses to pay compensation, it thinks that the insurance payment conditions are harsh, and the major illness insurance is called death insurance, and it thinks that the insurance company is fooling customers. The other equates primary cancer with in situ cancer, and refuses to compensate invasive cancer and primary cancer that has not yet metastasized as in situ cancer. Neither view is correct. The basic starting point of critical illness insurance is to provide financial support for the treatment of serious diseases and expensive diseases, and at the same time try to avoid the insured and their families from falling into financial difficulties. Cancer in situ is not easy to find in clinic because of its mild condition, and it is excluded from major diseases. In the future, with the gradual improvement of insurance varieties, cancer in situ may be included in the ranks of insurance diseases, which is not mentioned here for the time being. Appendiceal carcinoma in situ (ophthalmology), also known as Bowen's disease or intraepithelial carcinoma, is more common in the elderly and occurs at the junction of cornea and conjunctiva. Pathologically, it showed irregular epidermal hyperplasia. On the section, the polarity of epithelial cells is disordered, and normal cells are replaced by many heteromorphic or multinucleated heteromorphic cells, which belongs to real intraepithelial carcinoma. Generally, it recovered well after surgical resection. Breast lobular carcinoma in situ; It is a kind of carcinoma in situ of lobular duct and glandular epithelium of breast, which mostly occurs in 35-50 years old. It is characterized by multiple and bilateral features, which are not easy to be detected clinically and the pathological changes are not obvious. Further development can evolve into invasive lobular carcinoma with slow progress and good prognosis. Cervical carcinoma in situ; Pathological cells almost or completely occupy the whole process of epithelium, with abnormal enlargement of nucleus, obvious increase of nuclear-cytoplasmic ratio, irregular karyotype, deepened staining, increased mitotic period, crowded cells and nonpolarity. * * * * According to reports, cancer in situ mostly occurs in the mouth, lips, throat, stomach, lungs and even skin. It can be cured and is not a major disease. However, the incidence of cancer in situ in female reproductive organs is high, and the standard stipulates that cancer in situ is not guaranteed, but it is also clear that female disease insurance is excluded. Generally, cancer in situ is listed as an exclusion liability in critical illness insurance, while cancer in situ is listed as a coverage in women's critical illness insurance. Women who are worried about female cancer in situ can choose special female critical illness insurance to strengthen their own protection. The insurance companies' products for women's major diseases not only cover all kinds of cancers and common major diseases covered by general critical illness insurance, but also protect women's unique and susceptible diseases, including systemic lupus nephritis, severe rheumatoid arthritis and gynecological cancer in situ. For example, AIA's "Goddess of Protection" women's insurance specifically stipulates the insurance premium for women's cancer in situ, and Ping An Kangshun's "critical illness insurance for Life" and "China Life Care for Life" and other women's insurance products also have special provisions for cancer in situ. Female carcinoma in situ includes 7 lesions, which basically cover common gynecological diseases. However, the amount of compensation is lower than that of major diseases, which is generally about 20% of the insured amount. Mr. Li, manager of the insurance department of an insurance company, suggested that if social medical insurance is already available, women with average income can apply for health insurance and regular hospitalization insurance for specific diseases of women, or add health insurance products. Women with higher incomes can choose to buy relatively high-priced and comprehensive female health insurance and lifelong hospitalization medical insurance.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.