Changes in Cancer Mortality and Incidence in Australia 1987-2007 — ASN Events

Changes in Cancer Mortality and Incidence in Australia 1987-2007 (#253)

Freddy Sitas 1 2 3 , Alison Gibberd 3 , Clare Kahn 3 , Marianne Weber 3 , May Chiew 3 4 , Rajah Supramaniam 3 , Louisa Velentzis 3 , Carolyn Nickson 3 5 , David P Smith 3 6 , Dianne O'Connell 1 2 3 7 , Megan A Smith 3 8 , Katie Armstrong 3 , Xue Qin Yu 3 , Karen Canfell 3 8 , Monica Robotin 3 , Eleonora Feletto 3 , Andrew Penman 3
  1. School of Public Health , University of Sydney, Sydney, NSW
  2. School of Public Health and Community Medicine, University of NSW, Sydney, NSW
  3. Cancer Council NSW, Woolloomooloo, NSW, Australia
  4. National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
  5. Melbourne School of Public Health, University of Melbourne, Melbourne, VIC
  6. Griffith University, Brisbane, QLD
  7. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW
  8. Lowy Cancer Research Centre, University of NSW, Sydney, NSW

Aims

 From the late 1980s, various cancer control measures were implemented in Australia.  Our aim was to provide summary measures of changes in Australian cancer mortality and incidence since 1987, and to describe the context of these changes.

 Methods

 We used national data on mortality and newly registered cancer cases. We compared expected and observed numbers of cancer deaths and cases diagnosed in 2007, using 1987 as a baseline, for people under 75. The expected numbers were obtained by applying age-sex specific rates in 1987, estimated by averaging observed rates from 1986 to 1988, directly to the population in each age-sex group in 2007. The observed number of deaths and incident cases in 2007 was obtained by averaging the annual number of cases from 2006 to 2008.

 Results

 There was a 28% fall in cancer mortality (7,827 fewer deaths) and a 21% increase in new cancer diagnoses (13,012 more cases). The greatest changes in mortality were for Hodgkin’s lymphoma (-70%) and cervical cancer (-62%). We also observed falls in lung (-34%), colorectal (-47%), head and neck (-46%), breast (-31%) and stomach (-50%). There were little or no changes in mortality for cancers of the thyroid (-6%), pancreas (-6%) and oesophagus (-9%), or melanoma (-11%). In our analysis, only liver cancer mortality increased by 70% and other cancers by 15%.  Cancer types with increased incidence were prostate (+276%), thyroid (+198%) and liver (+132%), while falls in incidence were seen for cancers of the cervix (-52%), bladder (-51%) and unknown primary (-41%).

 Conclusion

 Cancer control measures in Australia seem to have been effective in reducing the number of cancer deaths, despite an overall increase in new cancer diagnoses. Prevention, improvements in treatment, and screening programs, all appear to have an important role in reducing mortality, and remain important elements of cancer control.