Cancer in Australia: an overview, 2008 is a joint report by the Australian Institute of Health and Welfare (AIHW) and the state and territory members of the Australasian Association of Cancer Registries (AACR). It presents the numbers of new cases of cancer and cancer deaths in 2005 as well as projections for 2006 to 2010. A wealth of other topics are covered, such as incidence of lymphohaematopoietic cancers using a modern classification scheme, cancers attributed to smoking and excessive alcohol consumption, incidence in the states and territories, incidence rates over the life span, cancer survival, cancer prevalence, cancer-related hospitalisations, the cancer screening programs and the burden of cancer. It is complemented by substantial online cancer data resources on the AIHW website.
In 2005, for the first time, there were over 100,000 new cases of cancer diagnosed in Australia. This number is projected to grow by over 3,000 extra cases per year in 2006-2010. The growth is due mainly to the ageing of Australia's population but there is also projected to be a small increase in the underlying cancer incidence rate.
The major cancer affecting males is prostate cancer, which accounted for over 29% of all diagnoses in 2005. For females the major cancer is breast cancer, which accounted for over 27% of all diagnoses in 2005. Each of these cancers had over double the number of diagnoses of the second most common cancer, which is colorectal cancer in both sexes. The next three most common cancers in both sexes are melanoma of the skin, lung cancer and lymphoma.
In 2005 there were over 39,000 deaths from cancer in Australia. The death rate from cancer is projected to decrease slightly during 2006-2010. Despite this, the actual number of deaths from cancer is projected to grow by over 800 extra deaths per year. This increase is due to the ageing of the population.
In both sexes the five biggest killers, in order, are lung cancer, prostate cancer (males)/breast cancer (females), colorectal cancer, cancer of unknown primary site and pancreatic cancer. For females, lung cancer overtook breast cancer in 2005 to become the biggest cancer killer of females for the first time. It is projected that lung cancer deaths in females will accelerate away from breast cancer deaths. This trend is caused by the increasing rates of smoking observed in women in the 1970s and 1980s. By contrast, male smoking rates were decreasing during this period and their lung cancer incidence and death rates today are also declining.
When analysed by age, cancer incidence rates were about the same for males and females until age 30. For ages 30 to 53 females had a higher rate than males, peaking at around 1.8 times higher at age 41. From age 55 onwards males had a higher rate, peaking at double the female rate at age 84.
The most common cancers faced by males over the life span are neuroblastoma as infants, lymphoid leukaemia from age 1 to 15, testicular cancer and melanoma of the skin from 16 to 29, melanoma of the skin from 30 to 51 and finally prostate cancer for the remainder of life. For females the most common cancers are neuroblastoma as infants, lymphoid leukaemia from age 1 to 14, Hodgkin lymphoma from 15 to 16, melanoma of the skin from 17 to 33, breast cancer from 34 to 75 and colorectal cancer from 76 onwards.
Survival from cancer was analysed in a recent separate report which is summarised in Chapter 10. It was found that cancers with the highest 5-year relative survival were testicular cancer (97% of cases still alive 5 years after diagnosis), thyroid cancer (93%) and melanoma of the skin (92%), whereas cancers with the lowest 5-year relative survival were pancreatic cancer (4.6%), cancer of unknown primary site (9.1%) and lung cancer (12%). Survival was also compared over time and found to be steadily improving for almost all cancers.
Increasing survival leads to increasing prevalence. At the end of 2004, over 650,000 living persons had been diagnosed with cancer at some time in the previous 23 years (when national data collection began). This represented about 1 in every 31 Australians.
Australia has three national cancer screening programs: for breast cancer, cervical cancer and colorectal cancer. These programs aim to detect disease early because, in most cases, the earlier a cancer or pre-cancerous disease is treated the better the chances of survival. Since the introduction of the National Cervical Screening Program deaths from cervical cancer have halved from 4.0 deaths per 100,000 women in 1991 to 1.9 deaths per 100,000 women in 2006. Since the introduction of BreastScreen Australia, deaths from breast cancer have decreased from 31 per 100,000 in 1991 to 22 per 100,000 in 2006. The National Bowel Cancer Screening Program is still in its early stages, but it is expected that it will also decrease mortality rates.
Cancer has a significant impact on the health system. A major report on the burden of disease in Australia, summarised in Chapter 14, found that the largest contributor to the total burden of disease in 2003 was cancer, accounting for 19% of the total.
One aspect of the burden of disease is hospital utilisation. In the financial year 2006-07 there were over 775,000 cancer-related separations from hospitals around the nation, which accounted for about 10% of all hospital separations in that year. Over 300,000 of these separations were due to chemotherapy sessions. The next four largest numbers of separations were due to non-melanoma skin cancer, special screening examinations, secondary cancers and follow-up after surgery for cancer. The number of hospital separations looks set to increase. For each year from 2002-03 to 2006-07 there was an increase of over 23,000 separations per year.
Due mainly to the aging of Australia's population, the number of people being diagnosed with cancer is projected to increase by over 3,000 extra cases per year, the number of hospital separations is projected to increase by over 23,000 extra separations per year and, despite the fact that the cancer death rate is expected to decrease, the actual number of deaths due to cancer is expected to increase by over 800 extra deaths per year. Cancer already has a major impact on individuals, families and the health system. Fuelled by Australia's ageing population, this situation looks set to continue.