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What is cancer?
Cancer is a diverse group of diseases in which some of the body cells become defective, begin to multiply out of control, can invade and damage the tissue around them, and may also spread (metastasise) to other parts of the body causing further damage.
Why is cancer control a National Health Priority Area?
Cancer has a major impact on the Australian community, in terms of morbidity, mortality and costs. Excluding the two main types of non-melanoma skin cancers (basal and squamous cell carcinomas), 104,592 new cases of cancer (59,058 males and 45,534 females) were diagnosed in Australia in 2006. (Australia's health 2010 pages: 134-136, June 2010)
In 2007 there were 39,884 deaths from cancer (29% of all deaths in 2007). Of these, 22,562 were of males (32% of all male deaths) and 17,322 were of females (26% of all female deaths). The average age at death was 72 years for both males and females. (Australia's health 2010 pages: 134-138, June 2010)
The NHPA Cancer Control initiative focuses on eight different types of cancers:
- lung cancer
- melanoma
- non-melanoma skin cancers
- colorectal cancer
- prostate cancer
- non-Hodgkin lymphoma
- cervical cancer
- breast cancer.
In 2007 there were 39,884 deaths from cancer. Of these, 22,562 were of males (32% of all male deaths) and 17,322 were of females (26% of all female deaths). The average age at death was 72 years for both males and females. It is projected that there will be around 43,700 deaths from cancer in 2010. (Australia's health 2010 pages: 136-138, June 2010).
What are the strategies for cancer control?
Efforts to control cancer involve research, primary prevention, early detection, treatment, services and support. The programs and tools for these activities vary with the type of cancer but mostly include a combination of all three.
Research support for cancer treatments has been provided through the National Health and Medical Research Council, and Cancer Australia.
Primary prevention includes public health programs to reduce the major risk factors; tobacco consumption, poor diet, insufficient physical activity, being overweight or obese, unsafe alcohol use, infectious diseases and exposure to ultraviolet radiation.
Early detection improves survival and other outcomes. National screening programs for cancers in Australia have contributed to substantial declines in associated mortality during the last decade. Screening can also help prevent the development of cancer if changes can be found before they become cancer.
The treatment of cancer is undertaken in various settings, including general practitioner surgeries (for skin cancers in particular) and through hospital inpatient and outpatient services. Treatments include surgery, radiotherapy, chemotherapy and counselling support services. Advances in each one of these areas are improving cancer outcomes. There are also many subsidies available for treatment services; the Pharmaceutical Benefits Scheme and Medicare Benefits Schedule cover all Australians for costs associated with services and medications.
Facilities and services to assist people with cancer have been improved with government funding. This has helped ensure that world class cancer facilities are accessible to all Australians. Examples of government funded services include: Regional Cancer Centres initiative, Integrated Cancer Centres, Children's Cancer Centre and the Olivia Newton-John Cancer and Wellness Centre.
Supportive care for people with cancer is very important from the time when cancer is a possibility. Accordingly, governments have provided funding for programs, such as specialist breast care nurses, respite for carers and support for youth cancer networks.
How is cancer monitored?
Regular surveillance and monitoring of various cancer control initiatives and strategies require tracking of different prevention, screening and treatment modalities, risk factor reduction, and premature mortality. In Australia, cancer is a notifiable disease and all States and Territories have established registries to collect data on cancer incidence and mortality. Information on some of the major risk factors such as tobacco smoking and excessive alcohol consumption is generated by the Australian Bureau of Statistics and other national agencies through a variety of surveys.
Cancer is projected to be the leading cause of the burden of disease and injury in Australia in 2010, as it has been at least since 2003. It is estimated that it will account for 19% of the total burden, compared with 16% for CVD which is the second leading cause. (Australia's health 2010 pages: 138-140, June 2010)