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Mortality and Morbidity: Cancer trends
Cancer deaths 1973-93 In 1993, the standardised death rate in Australia was lower than in 1973. This was mainly due to advances in medical technology, and the leading of healthier lifestyles through better diets, regular exercise, and reduction in tobacco and alcohol consumption. The result of these changes is that people were more likely to die from cancer in 1993 because they were not dying from other causes of death at earlier ages. In 1993, cancers were the leading cause of death, exceeding heart attacks by almost 3,000 deaths. Of the major causes of death in 1993 (including cancers, heart attacks and strokes) only the death rate from cancer had increased since 1973. The cancer death rate increased from 173 deaths per 100,000 population in 1973 to 180 deaths per 100,000 population in 1993. In comparison the death rate from heart attacks in 1993 was almost half the rate recorded in 1973. Both male and female cancer death rates rose between 1973 and 1993. The rate for males rose more rapidly than the rate for females. Males are more likely to die from cancer than females. In 1993 the cancer death rate for males was 236 per 100,000 population, while for women it was 141. In the past men were more likely than women to smoke, consume alcohol and experience other health risk factors such as occupational stress. These factors have contributed to the higher cancer death rates for men compared to women. Of the leading cancer death rates, only those for stomach cancer declined significantly between 1973 and 1993. This decline, and the lower death rate from heart disease, could reflect changes in people's diets. Between 1973 and 1993, age-specific cancer death rates decreased for both males and females in all age groups except for those aged 65 and over. Men had higher age-specific cancer death rates than women after the age of 50. In 1993, the age-specific cancer death rate for men aged 65 and over was nearly twice the rate observed in women. The higher cancer death rate of older men reflects the higher risk men have of developing cancer later in life than women. Men die of prostate cancer later in life, while women die of breast cancer at younger ages. LEADING CANCER DEATHS, 1993
STANDARDISED CANCER DEATH RATE(a)
(b) Caution should be used in comparing these cancers due to minor classification changes between 1973 and 1993. Source: Causes of Death AGE-SPECIFIC CANCER DEATH RATES
Lung cancer In 1993, 4,552 males and 1,828 females died of lung cancer. This accounted for 25% of all male cancer deaths and 13% of all female cancer deaths. The lung cancer death rate for men was over twice the rate for women. Lung cancer is often preventable and has been linked to lifestyle patterns such as smoking. The differences between men's and women's lung cancer death rates can be linked to differences in smoking behaviours (see Australian Social Trends 1994, Tobacco use). In 1993, 96% of people who died from lung cancer were over the age of 50. Half of all people who died from lung cancer were aged over 70. Educating people about ways of preventing lung cancer, such as quitting smoking, will help to decrease the lung cancer death rate. however, there is a long lag period between changes in smoking behaviour and falling lung cancer death rates. Therefore, lung cancer is likely to remain a leading cause of death for many years2 LUNG CANCER DEATHS BY AGE, 1993 Source: Causes of Death Breast cancer In 1993, breast cancer was the most common type of cancer death in women, accounting for 2,641 deaths. Breast cancer deaths accounted for around 1 in 5 female cancer deaths. Over one-third of all breast cancer deaths in women occurred before the age of 60. 17% occurred before the age of 50. Breast cancer is a major health concern because it is more likely than other cancers to affect women at early ages. It can also be successfully treated if detected early through examination and screening procedures. Screening is currently recommended in Australia for all women aged 50-692. BREAST CANCER DEATHS BY AGE, 1993 Source: Causes of Death Prostate cancer In 1993, 2,544 men died of prostate cancer. Prostate cancer has been a leading contributor to the rise in cancer deaths in older men. In 1993, 97% of prostate cancer deaths occurred in men aged over 60. 80% of prostate cancer deaths occurred in man aged over 70. The prostate cancer death rate increased between 1973 and 1993, mainly because fewer men are dying from other causes at younger ages. However, the increase may also reflect a generally low health awareness. Greater education on screening for prostate cancer is needed to reduce the growing number of prostate cancer deaths. PROSTATE CANCER DEATHS BY AGE, 1993 Source: Causes of Death Colon Cancer In 1993, colon cancer was the third largest cause of cancer mortality for both men and women. In 1993, it accounted for 1,706 male deaths and 1,602 female deaths. Most men and women (94%) died of colon cancer after the age of 50. COLON CANCER DEATHS BY AGE, 1993 Source: Causes of Death
Incidence of cancer Males have a higher cancer incidence rate than females. However, between 1982 and 1988, cancer incidence rates rose more rapidly for females than males. For males, cancer incidence rates were highest for lung cancer, melanoma, colon cancer and lung cancer. For females they were highest for breast cancer, followed by melanoma, colon cancer and lung cancer. Between 1982 and 1988, the incidence rate for melanoma increased more rapidly than for any other type of cancer. Melanomas increased from 18 new cases diagnosed per 100,000 population for both males and females in 1982, up to 33 for males and 28 for females in 1988. This rise in incidence may be due to increased awareness, and subsequent detection, through skin cancer awareness campaigns. The likelihood of surviving cancer can be measured by the difference between the cancer incidence rate and the cancer death rate. The difference varies between cancers. Melanomas, which rarely lead to death, have a high incidence rate and low mortality rate. In contrast, the difference for lung cancer is smaller. Men are more likely to develop, and die from, cancer than women. In 1988, the probability of a male being diagnosed with cancer during his lifetime was 1 in 3, compared to 1 in 4 for a female. The probability of dying from cancer was 1 in 6 for males and 1 in 9 for females3. However, these probabilities do not take into account other competing causes of death. INCIDENCE RATES OF CANCER(a)
Source: Australian Institute of Health & Welfare Cancer in Australia
Endnotes 1 Australian Institute of Health and Welfare and the Australasian Association of Cancer Registries (1992) Cancer in Australia, 1983-85. 2 Australian Institute of Health and Welfare (1992) Australia's Health 1992: the 3rd biennial report of the Australian Institute of Health and Welfare. 2 Australian Institute of Health and Welfare unpublished data.
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