Australia has one of the highest rates of cancer incidence worldwide and, despite improving survival, cancer continues to be a public health problem. We used national data on mortality and newly registered cancer cases to compare expected and observed numbers of cancer deaths and incident cases in 2007. There was a 28% fall in cancer mortality (7827 fewer deaths in the single year 2007) and a 21% increase in new cancer cases (13012 more diagnosed cases). The reduction in cancer mortality indicates that prevention strategies, improvements in cancer treatment, and screening programs have made significant contributions to cancer control in Australia since 1987.

1. Changes in cancer
mortality and incidence
in Australians under 75
years of age: 1987-2007
Sitas F1,2,3, Gibberd A1, Kahn C1, Weber M1, Chiew M1,4, Supramaniam R1, Velentzis L1, Nickson C1,5, Smith
DP1,6, O’Connell D1,2,3,7, Smith MA1*, Armstrong K1, Yu XQ1,2, Canfell K1,2*, Robotin M1,2, Feletto E1, Penman A1.
1. Cancer Council NSW. 2. University of Sydney. 3. University of NSW. 4. Australian National University.
5. University of Melbourne. 6. Griffith University. 7. University of Newcastle.
*Present address: University of NSW
Aims
Australia has one of the highest rates of cancer incidence worldwide and, despite improving
survival, cancer continues to be a public health problem.1,2 Our aim was to provide
summary measures of changes in Australian cancer mortality and incidence since 1987, so
that progress and areas for improvement in cancer control can be identified.
Methods
We used national data on mortality and newly registered cancer cases to
compare expected and observed numbers of cancer deaths and incident
cases in 2007. The expected numbers were obtained by applying age-sex
specific rates in 1987 (average 1986 to 1988) to the population in each agesex group in 2007. The observed number of deaths and incident cases in 2007
(average 2006 to 2008) were calculated. We limited the analyses to people
aged less than 75 years of age.
Results
There was a 28% fall in cancer mortality (7827 fewer deaths in the single year
2007) and a 21% increase in new cancer cases (13012 more diagnosed
cases) (Figure 1). The greatest reductions in deaths were for cancers of the lung in
males (-2259), colorectal (-1797), female breast (-773) and stomach (-577). Other
notable falls were for cancers of the prostate (-295), cervix (-242) and non-Hodgkin
lymphoma (-240). Only small or no changes occurred in mortality for cancers of
the lung in females, pancreas, brain and related, oesophagus and thyroid, with an
increase only observed for liver cancer (267). Cancer types that showed the greatest
increase in incident cases were cancers of the prostate (10245), breast (2736),
other cancers (1353), melanoma (1138) and thyroid (1107), while falls were seen for
cancers of the lung (-1705), bladder (-1110) and unknown primary (-904).
Figure 1: Difference in observed and expected number of deaths and incident cases
(under 75 years of age) by cancer type in Australia: 1987 vs 2007
All cancers
Lung
Colorectal
Breast (female)
Stomach
Head and Neck
Unknown primary
Prostate
Cervix
Non-Hodgkin lymphoma
Bladder
Kidney
Ovary
Brain and related
Melanoma
Hodgkin lymphoma
Pancreas
Oesophagus
Uterus
Deaths
Thyroid
Incident cases
Incident cases (%)
Liver
Mortality (%)
Other cancers
-10000
-5000
0
5000
10000
15000
Difference: Observed - Expected
Conclusions
The reduction in cancer mortality indicates that prevention strategies, improvements in
cancer treatment, and screening programs have made significant contributions to cancer
control in Australia since 1987. The rise in cancer incidence is partly due to diagnoses
being brought forward by technological improvements in medical investigations and
increased coverage of screening and early diagnostic testing. Notably, prostate cancer
was responsible for about 80% of the increase in number of incident cases.
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References
1. AIHW. Asia Pac J Clin Oncol 2011; 17,(4): 325-338
2. GLOBOCAN 2008 v2.0. Cancer Incidence &
Mortality Worldwide: IARC Cancer Database
No.10. http://globocan.iarc.fr