This publication provides a brief overview of the differentials in prevalence and incidence of the types of cancer suffered, cancer screening practices, trends in morbidity and mortality in Australia. Data regarding persons living outside hospitals, nursing and convalescent homes and hospices in Australia are provided from the 2001 National Health Survey, while other data is provided from both ABS and other sources.
For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070 or Saul Flaxman on Canberra (02) 6252 5782.
Cancer (or malignant neoplasm) occurs when cell growth becomes uncontrolled and abnormal cells reproduce and spread. This results in a mass of tissue called a tumour. Tumours can be either benign (non-cancerous) or malignant (cancerous). Cancer refers to several diseases and can affect most types of cells in various parts of the body.
This article presents information from a number of sources, including the 1995 and 2001 ABS National Health Survey (NHS), 2000 and 2002 Causes of Death data, and national cancer registry data published by the AIHW. It should be noted that the 1995 and 2001 NHS excluded persons in hospitals, nursing and convalescent homes and hospices and hence the data relates only to persons in private dwellings. Other sources of data have been included for a more complete view. These include published cancer registry data. The registration of all cancers (excluding non-melanoma skin cancer) is required by law in each of the states and territories and data about people with newly diagnosed cancer from hospitals, pathologists, radiation oncologists (cancer specialists), cancer treatment centres and nursing homes are collated by cancer registries.
CALCULATION OF RATES
In this publication incidence and prevalence rates are presented. Incidence refers to the number of new cases of a particular characteristic, such as cancer, which occur within a certain period. This differs from prevalence, which refers to the number of cases of a particular characteristic that are present in a population at one point in time. Incidence and prevalence rates are proportions of the population of interest.
- After adjusting for age differences in the population, 16 persons per 1,000 living in private dwellings in 2001 (20 per 1,000 males and 14 per 1,000 females) had a medically diagnosed neoplasm (ABS 2001).
- Between 1995 and 2001, after adjusting for age differences, the proportion of males in private dwellings reporting a medically diagnosed neoplasm stayed the same (19 males per 1,000 in 1995 compared to 20 males per 1,000 in 2001) while the proportion of females reporting neoplasms decreased from 18 females per 1,000 in 1995 to 14 females per 1,000 in 2001 (ABS 1995 and 2001).
- Of those reporting a neoplasm in 2001, 84% reported a malignant neoplasm (cancer) and 16% reported a benign neoplasm or neoplasm of an uncertain nature.
- For both males and females in private dwellings, cancer was most prevalent in the 65 years and over age group (8% of males and 3% of females in this age group reported having cancer).
- Just over half (53%) of both males and females in private dwellings with skin cancer in 2001 were aged less than 65 years.
- The most common cancers for persons living in private dwellings who reported a malignant neoplasm were skin cancer (36%), cancer of the digestive organs (11%) and breast cancer (26% of females who reported a malignant neoplasm).
- There was no difference in cancer prevalence rates between those living in areas with the greatest disadvantage (those in the lowest quintile of the index of socioeconomic disadvantage) and those living in areas with the least disadvantage (those in the highest quintile of the index of socioeconomic disadvantage).
- Although cancer was the leading cause of death in all areas, in 2000 the death rate amongst those living in areas with the most disadvantage (2.0 deaths per 1,000 persons) was 15% higher than the least disadvantaged (1.7) for this cause (ABS 2001a).
- Cancers of the digestive organs and lungs (and other smoking-related cancers) are the most common types of cancer that lead to deaths among Aboriginal and Torres Strait Islander peoples (ABS 2004).
- Age-specific death rates from cancer are consistently higher for Indigenous Australians (up to two times higher) for all age groups over 45 years (with the exception of Indigenous women aged over 75 years) (ABS 2004, ABS & AIHW 2003).
INCIDENCE OF CANCER
INCIDENCE OF SELECTED CANCERS (a) - 2000
- Data from cancer registries show that in 2000 colorectal cancers (footnote 1) were the most common newly diagnosed cancers with 12,405 new cases of bowel or colorectal cancer reported (AIHW & AACR 2003).
- In 2000, prostate cancer was the most common diagnosed registrable cancer among males (10,512 new cases diagnosed). Following prostate cancer, the most common registrable cancers in males were colorectal cancers (6,863 new cases diagnosed), lung cancer (5,278) and melanoma (4,770) (AIHW & AACR 2003).
- Breast cancer was the most common newly diagnosed cancer among females in 2000 (11,314 new cases diagnosed). After breast cancer, colorectal cancer (5,542 new cases diagnosed in 2000), melanoma (3,761) and lung cancer (2,782) were the next most common registrable cancers among females (AIHW & AACR 2003).
- During 1992-97, the five-year relative survival proportions for all cancers for females (63%) were higher than those for males (57%). For cancer of the colon, the five year survival rate was similar for males and females (58% and 59% respectively). Differences in survival rates between males and females were observed for people diagnosed with rectal cancer and lung cancer. For rectal cancer, five year survival rates were 57% for males and 61% for females. Five year survival rates for lung cancer were markedly lower, 11% for males and 14% for females. In males, the five-year relative survival rate for prostate cancer was 83% while 84% of females were still surviving five years after being diagnosed with breast cancer (ABS 2004a).
CANCER SCREENING PRACTICES
Breast, cervical and bowel cancer are three of the types of cancer where there is evidence that illness and death can be reduced through population-based screening and effective follow-up treatment (AIHW & AACR 2003).
MAMMOGRAMS AND PAP SMEAR TESTS
Information from the 2001 NHS includes diagnostic tests as well as screening mammograms and pap smears for those living in private dwellings.
- Mammographic screening for breast cancer is aimed specifically at women aged 50-69 years without symptoms, although women aged 40-49 years and 70 years and older may also attend for screening (AIHW & AACR 2003).
- 72% of females living in private dwellings aged 50-69 have mammograms at least once every two years.
- 53% of females aged 18 years and over have pap smears at least once every two years. Of women aged 30-39, 73% have pap smear tests at least once every two years compared to 14% of women aged 70 years and over.
- In the period 1999-00 to 2001-02 (where all coding has been in ICD-10-AM), cancer-related hospital separations increased on average by 5.5% per annum. Cancer-related separations accounted for 9.7% of all hospital separations in 2001-02 (AIHW & AACR 2003).
- 13% of all same-day separations in 2001-02 were cancer-related (AIHW & AACR 2003).
- Non-melanomic skin cancers (NMSC) comprised 11% of all cancer-related hospital separations (AIHW & AACR 2003).
TRENDS IN MORBIDITY/ BURDEN OF DISEASE
- Cancers contributed more to loss of potential life years than any other causes of death analysed. In 2000, 27% of all potential life years lost (or 257,800 years) were lost to cancers (ABS 2001a).
- In 1996, cancer contributed 19% to the total disability-adjusted life years (DALY) (footnote 2) (AIHW 2004).
DEATH RATES FOR SELECTED CANCERS (a) - 2002
- Cancer was the leading underlying cause of death in Australia in 2002, causing 28% of all deaths (ABS 2003).
- Although childhood cancer is relatively uncommon, cancer is a leading cause of death among children aged 1-14 years. Cancer was the underlying cause of 19% of all deaths of children in this age group in 2002 (ABS 2004, ABS 2003).
- Lung cancer (footnote 3) was the most common cause of death by cancer among men, causing 23% of all cancer deaths in 2002. The next most common cause of cancer death for males was prostate (14%) followed by colorectal cancers (12%) (footnote 1) (ABS 2003).
- In females, the cancers most commonly causing death were breast (16% of all female cancer deaths in 2002), lung (15%) and colorectal cancers (13%) (ABS 2003).
- Although skin cancers are the most commonly diagnosed cancer in Australia, relatively few people die of this cancer if treated early (ABS 2004).
1. Colorectal cancer refers to cancer of the colon, rectosigmoid junction, rectum, anus and anal canal (IC10 C18-C21). Back
2. DALY refers to years of healthy life lost through premature death or living with disability due to illness or injury. DALYs are used to measure the burden of disease which includes both morbidity and mortality.Back
3. In this publication, lung cancer refers to cancer of the trachea, bronchus and lung (IC10 C33-C34). Back
Australian Bureau of Statistics 2004, Australian Social Trends 2004, cat. no. 4102.0, ABS, Canberra.
Australian Bureau of Statistics 2004a, Year Book Australia 2004, cat. no. 1301.0, ABS, Canberra.
Australian Bureau of Statistics 2003, Causes of Death Australia, 2002, cat. no. 3303.0, ABS, Canberra.
Australian Bureau of Statistics 2003a, Deaths, Australia, 2002, cat. no. 3302.0, ABS, Canberra.
Australian Bureau of Statistics 2002a, National Health Survey: Summary of Results, Australia, 2001, cat. no. 4364.0, ABS, Canberra.
Australian Bureau of Statistics 2001, National Health Survey, Australia, 2001. Data available on request.
Australian Bureau of Statistics 2001a, Deaths, Australia, 2000, cat. no. 3302.0, ABS, Canberra.
Australian Bureau of Statistics 1999, Disability, Ageing and Carers, Australia: Summary of Findings, 1998, cat. no. 4430.0, ABS, Canberra.
Australian Bureau of Statistics 1995, National Health Survey, Australia, 1995, Data available on request.
Australian Bureau of Statistics & Australian Institute of Health and Welfare 2003, The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples 2003, ABS cat. no. 4704.0; AIHW cat. no. IHW-11, ABS & AIHW, Canberra.
Australian Institute of Health and Welfare 2004, Australia's Health, 2004, AIHW cat. no. AUS 44, AIHW, Canberra.
Australian Institute of Health and Welfare & Australasian Association of Cancer Registries 2003, Cancer in Australia 2000. AIHW cat. no. CAN 18, AIHW, Canberra.