Summary
Cancer is a major cause of illness in Australia, where it is responsible for 18% of the burden of ill health suffered by Australians, and almost 9% of health system expenditure attributable to specific diseases.
There are over 1 million people alive in Australia who are either currently living with or have lived with cancer. This number is expected to grow over time as both cancer incidence and cancer survival continue to increase. In 2021, it is estimated that 151,000 people will be diagnosed with cancer (excluding basal cell carcinomas (BCC) and squamous cell carcinomas (SCC) of the skin), and 49,000 people will die as a result of cancer. Influenced by population growth and older people becoming a larger proportion of the population (Australia’s ageing population), the number of new cases of cancer diagnosed is estimated to increase to 185,000 in 2031.
Cancer survival varies from cancer to cancer but overall cancer survival has improved, with 70% of all people diagnosed with cancer (excluding BCC and SCC) surviving at least five years after diagnosis; up from 51% about 30 years ago.
Almost half (42%) of the cancer burden is attributable to personal and behavioural risk factors (for example, smoking and overweight). Understanding and avoiding the risk factors associated with cancer can help to reduce the chance of getting cancer, while participation in cancer screening programs can increase the likelihood of detecting cancer early, enabling better outcomes from treatments. Improvements in cancer treatments and care are also important contributors to improvements in survival.
The age-standardised incidence rate of cancer has decreased from a peak of 508 cases per 100,000 people in 2008, to an estimated 486 cases per 100,000 people in 2021, influenced by strong decreases in prostate cancer incidence, likely linked to previous changes in diagnostic guidelines. If prostate cancer is excluded, the all-cancer incidence rate for males has been relatively stable over the past 20 years. On the other hand, the all-cancer incidence rate for females has increased from 404 to an estimated 441 cases per 100,000 females. Increasing incidence rates for females reflects, amongst other things, an increase in the incidence rate of lung cancer due to the historical increase in the smoking rate amongst females.
Over the past 20 years, incidence rates for most of the common cancers have increased. However, some have remained steady and others have decreased.
Cancer mortality rates continue to fall, with a sharper decline for males than for females. Between 1989 and 2021, age-standardised cancer mortality rates have declined substantially for both males and females from 287 to an estimated 182 deaths per 100,000 males, and from 165 to an estimated 122 deaths per 100,000 females.
Cancer incidence and survival outcomes are not evenly spread across the population. For example:
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On average, Indigenous Australians were 14% more likely to be diagnosed with cancer and 20% less likely to survive at least five years after diagnosis compared with non-Indigenous Australians. Survival for Indigenous Australians was lower in regional and remote areas than in other areas.
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Cancer incidence rates were slightly higher in regional areas, while survival declined with increasing remoteness, at least partially reflecting poorer survival for Indigenous Australians in more remote areas.
- Compared with people living in the least socioeconomically disadvantaged areas, cancer incidence rates for people living in the most disadvantaged areas were 5% higher, but survival rates were almost 20% lower, and cancer mortality rates were over 40% higher.
In this report, rare and less common cancers are defined as those with incidence rates lower than 12 cases per 100,000 people. While 30% of all cancers diagnosed are classified as rare or less common cancers, these are responsible for 42% of all cancer deaths.
The effect of the COVID-19 pandemic on cancer diagnosis and treatment
The COVID-19 pandemic appears to have had at least some effect on the uptake of cancer-related services. In this report, the incidence data presented for 2021 are estimates based on the latest available information and time-series trends to 2017. These estimates do not take into account the potential impact of COVID-19 on cancer diagnoses. Fewer people may have been diagnosed with cancer during COVID-19 restrictions than would otherwise have been the case.
After having increased by an average of 1% per year over the previous 20 years, the rate of cancer-related hospitalisations decreased by 1% between 2018–19 and 2019–20, noting that COVID-19 restrictions were in place only during the last quarter of 2019–20. COVID-19 restrictions also appear to have affected uptake of breast ultrasound, mammography, breast MRI and colonoscopy. For example, the number of people having MBS-subsidised colonoscopies was 11% lower in 2020 compared with 2019, following average growth of around 3% per annum since 2011.
The full impact of the COVID-19 pandemic on cancer diagnosis and treatment will not be known for several years.
Summary
Data at a glance
- Estimated incidence of cancer in 2021 (by sex)
- Estimated mortality from cancer in 2021 (by sex)
- Estimated cancer incidence and mortality in 2021
1. Introduction
- Cancer
- Report overview
- Data sources
- Data presentations
- Reference years
- Data projections
- Aggregating data
2. Risk factors for cancer
- Determining associations between risk factors and cancer
- Types of risk factors
- Cancer risk factors in Australia
- Cancer burden attributable to specific risk factors
- Tobacco use
- Overweight and obesity
- Alcohol use
- Dietary risks
- High sun exposure
- Diabetes
- Occupational exposures and hazards
- Physical inactivity
3. Cancer projections and Australia’s ageing population
- Changes in cancer counts over 20 years
- The number of cancers diagnosed is estimated to have increased by 64% over 20 years
- Population growth for older age groups is far greater than for younger age groups
- Cancer is more common in older age groups
- For most older age groups, the cancer incidence rate growth mirrors population growth
- Cancer incidence projections for 2031
- More than 1.7 million cases of cancer are estimated to be diagnosed over the next 10 years
- Australia’s ageing population is expected to continue to contribute to higher cancer counts
- Cancer incidence projections
4. Screening and early detection
- Population-based cancer screening
- BreastScreen Australia—more than 1.8 million women screened in 2018–2019
- National Cervical Screening Program—transition to a renewed screening program
- National Bowel Cancer Screening Program—females participating at greater rates than males
- MBS-subsidised surveillance, detection and monitoring services
- Breast imaging (female only)
- MBS-subsidised prostate-specific antigen tests
- MBS-subsidised colonoscopies
5. Number of new cancer cases
- All cancers combined
- More than 150,000 cases of cancer are estimated to be diagnosed in 2021
- The number of new cancer cases continues to rise
- Cancer incidence rates for males and persons are more stable when prostate cancer is excluded
- How incidence of the most commonly diagnosed cancers has changed
- Changes in cancer incidence rates in all ages combined
- Changes in cancer incidence rates by age group
6. Treatment
- Hospitalisations for all cancers combined
- Average length of stay for overnight cancer-related hospitalisations
- Hospitalisation rates by age group and sex
- Changes in numbers and rates of cancer-related hospitalisations
- Cancer types most commonly recorded as the principal diagnosis for hospitalisations
- Most common cancers recorded as principal diagnosis by sex
- Chemotherapy for cancer
- MBS-subsidised chemotherapy services and vascular surgical operations for chemotherapy services
- Chemotherapy procedures for cancer-related hospitalisations
- Most common principal diagnoses for hospitalisations where chemotherapy was performed
- Most common additional diagnoses for hospitalisations where chemotherapy was performed
- Radiotherapy for cancer
- MBS-subsidised radiotherapy services
- Radiotherapy procedures for cancer-related hospitalisations
- Most common principal diagnoses for hospitalisations where radiotherapy was performed
- Most common additional diagnoses for hospitalisations where radiotherapy session was the principal diagnosis
- Courses of radiotherapy
- Hospitalisations for palliative care for cancer
7. Survival and survivorship after a cancer diagnosis
- Survival
- All cancers combined
- Cancer types
- International comparisons
- Conditional survival
- All cancers combined
- Cancer types
- Survivorship populatio
- All cancers combined
- Cancer types
- Life after cancer
- Experiences after cancer
8. Number of deaths
- All cancers combined
- Mortality by age group and sex
- Trends
- How most common causes of death from cancer have changed over 20 years
- Changes in cancer mortality rates in all ages combined
- Changes in cancer mortality rates for people aged 0–19
- Changes in cancer mortality rates for people aged 20–39
- Changes in cancer mortality rates for people aged 40–59
- Changes in cancer mortality rates for people aged 60–79
- Changes in cancer mortality rates for people aged 80 and over
9. Rare and less common cancers
- Incidence by cancer rarity
- Rare cancers are more commonly diagnosed in people under 30 than either common or less common cancers
- Survival by cancer rarity
- Mortality by cancer rarity
- Experiences after being diagnosed with cancer
- Different ways to consider cancer by rarity (technical note)
10. Key population groups
- Aboriginal and Torres Strait Islander people
- Cancer incidence rates for Indigenous Australians
- Cancer survival rates for Indigenous Australians
- Cancer mortality rates for Indigenous Australians
- Remoteness area
- Cancer incidence rates across remoteness areas
- Cancer survival rates by remoteness area
- Cancer mortality rates by remoteness area
- Socioeconomic area
- Cancer incidence rates by socioeconomic area
- Cancer survival rates by socioeconomic area
- Cancer mortality rates by socioeconomic area
11. Non-malignant tumours
- Carcinoma in situ of the breast (female only)
- Carcinoma in situ of the cervix
- Melanoma in situ of the skin
- Non-malignant neoplasms of the brain and other central nervous system
Appendix A: Methodology for 2017 cancer incidence for NT and cancer projections
Appendix B: Cancer codes
Appendix C: Data sources
Appendix D: Definition of cancer-related hospitalisations
Appendix E: Statistical methods and technical notes
Appendix F: Enhancements and other events affecting data
Appendix G: Classifications
End matter: Acknowledgments; Abbreviations; Symbols; Glossary; References; List of tables; List of figures; List of boxes; Related publications