The State of Cancer Control in Australia 1987-2007: Changes in Cancer Incidence and Mortality 2 • the State of Cancer Control in Australia
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The State of Cancer Control in Australia 1987-2007: Changes in cancer incidence and mortality 2 • The State of Cancer Control in Australia Cancer Council NSW November 2013 Authors Eleonora Feletto Alison Gibberd Clare Kahn Katie Armstrong Karen Canfell May Chiew Paul Grogan Carolyn Nickson Dianne O’Connell Andrew Penman Monica Robotin David P Smith Megan A Smith Rajah Supramaniam Louiza Velentzis Marianne Weber Xue Qin Yu Freddy Sitas Acknowledgments The authors would like to thank Mark Short at the Australian Institute of Health and Welfare and Julia Fitzgerald from the Australian Bureau of Statistics for compiling the tables for us, and for providing invaluable advice on ICD changes and conversion codes. We would also like to thank Priscilla Johnson, Associate Professor Peter Baade and Professor Bernard W Stewart for reviewing the document. ISBN 978-1-921619-95-3 Key words: Cancer control, Australia, neoplasms, incidence, mortality, cancer Suggested citation: Feletto E, Gibberd A, Kahn C, Armstrong K, Canfell K, Chiew M, Grogan P, Nickson C, O’Connell D, Penman A, Robotin M, Smith DP, Smith MA, Supramaniam R, Velentzis L, Weber MF, Yu XQ, Sitas F. The State of Cancer Control in Australia: 1987–2007: Changes in cancer incidence and mortality. Sydney: Cancer Council NSW; 2013. Published by Cancer Council NSW 2013 November, 2013 Table of Contents 1. Abbreviations 9 2. Report Overview 11 3. Executive Summary 13 3.1. Background 13 3.2. Aims 13 3.3. Methods 14 3.4. Results 14 3.4.1. Breast cancer 14 3.4.2. Cervical cancer 14 3.4.3. Colorectal cancer 15 3.4.4. Liver cancer 15 3.4.5. Lung cancer 15 3.4.6. Melanoma 15 3.4.7. Prostate cancer 16 3.4.8. Stomach cancer 16 3.4.9. Australian approach to health care and cancer control 16 3.5. Discussion 17 3.6. Conclusion 17 4. Introduction 21 5. Methods 25 5.1. Incidence and mortality changes 25 5.2. National policy development 26 6. Results: analysis of findings overall – incidence and mortality 29 6.1. Changes in mortality 29 6.2. Changes in incident cases 30 6.3. Overall changes 34 7. Results: analysis of cancer types - incidence and mortality 37 7.1. Breast cancer (C50) 39 7.1.1. Background 39 7.1.2. Incidence and mortality rates in Australia, 1987–2007 42 7.2. Cervical cancer (C53) 44 7.2.1. Background 44 7.2.2. Incidence and mortality rates in Australia, 1987–2007 49 7.3. Colorectal cancer (C18–C20) 55 Cancer Council NSW • 3 4 • The State of Cancer Control in Australia 7.3.1. Background 55 7.3.2. Incidence and mortality rates in Australia, 1987–2007 58 7.4. Liver cancer (C22) 63 7.4.1. Background 63 7.4.2. Incidence and mortality rates in Australia, 1987–2007 65 7.5. Lung cancer (C33–C34) 68 7.5.1. Background 68 7.5.2. Incidence and mortality rates in Australia, 1987–2007 72 7.6. Melanoma (C43) 77 7.6.1. Background 77 7.6.2. Incidence and mortality rates in Australia, 1987–2007 79 7.7. Prostate cancer (C61) 83 7.7.1. Background 83 7.7.2. Incidence and mortality rates in Australia, 1987–2007 85 7.8. Stomach cancer (C16) 89 7.8.1. Background 89 7.8.2. Incidence and mortality rates in Australia, 1987–2007 91 8. Cancer control policies, programs and emerging issues 95 8.1. Cancer as a non-communicable disease and cancer control 95 8.2. Cancer control globally 96 8.2.1. Role of NGOs 97 8.3. Australian approach to cancer control 98 8.3.1. Health care in Australia 98 8.3.2. Evolution of cancer control and related policies in Australia 99 8.3.3. Government agencies 102 8.3.4. Australian cancer control policy 102 8.3.5. Existing cancer control–related programs and initiatives 103 8.3.6. Cancer control data sources: monitoring of trends 110 8.4. Cancer control in practice 111 8.4.1. Cancer care: key elements and emerging issues 111 8.4.2. Discovery and advancement in prevention, diagnosis and treatment 113 8.4.3. Cancer control implementation process and leadership 114 8.5. Summary of cancer control policies, programs and emerging issues 116 November, 2013 9. Discussion and future research 127 9.1. Burden of early diagnosis 128 9.2. Health records 128 9.3. Implications for the ageing population 128 9.4. Focus on prevention 129 9.5. Evidence-based interventions and government decision-making 129 9.6. Dilemmas in cancer control 129 9.7. Future research 130 10. Conclusion 133 11. References 135 Cancer Council NSW • 5 6 • The State of Cancer Control in Australia Figures Figure 6–1 Age-standardised cancer mortality rates in Australia 1987–2007, 0–74 years 30 Figure 6–2 Age-standardised cancer incidence rates in Australia 1987–2007, 0–74 years 31 Figure 6–3 Change in cancer incident cases and mortality in Australia from 1987–2007 – MALES 34 Figure 6–4 Change in cancer incident cases and mortality in Australia from 1987–2007 – FEMALES 35 Figure 6–5 Change in cancer incident cases and mortality in Australia from 1987–2007 – PERSONS 36 Figure 7–1 Breast cancer: age-standardised cancer mortality rates in Australia 1987–2007, 0–74 years 42 Figure 7–2 Breast cancer: age-standardised cancer incidence rates in Australia 1987–2007, 0–74 years 42 Figure 7–3 Cervical cancer: age-standardised cancer mortality rates in Australia 1987–2007, 0–74 years 50 Figure 7–4 Cervical cancer: age-standardised cancer incidence rates in Australia 1987–2007, 0– 74 years 50 Figure 7–5 Colorectal cancer: age-standardised cancer mortality rates in Australia 1987–2007, 0–74 years 58 Figure 7–6 Colorectal cancer: age-standardised cancer incidence rates in Australia 1987–2007, 0–74 years 58 Figure 7–7 Liver cancer: age-standardised cancer mortality rates in Australia 1987–2007, 0–74 years 66 Figure 7–8 Liver cancer: age-standardised cancer incidence rates in Australia 1987–2007, 0–74 years 66 Figure 7–9 Lung cancer: age-standardised cancer mortality rates in Australia 1987–2007, 0–74 years 72 Figure 7–10 Lung cancer: age-standardised cancer incidence rates in Australia 1987–2007, 0–74 years 72 Figure 7–11 Melanoma: age-standardised cancer mortality rates in Australia 1987–2007, 0–74 years 80 Figure 7–12 Melanoma: age-standardised cancer incidence rates in Australia 1987–2007, 0–74 years 80 Figure 7–13 Prostate cancer: age-standardised cancer mortality rates in Australia 1987–2007, 0–74 years 86 Figure 7–14 Prostate cancer: age-standardised cancer incidence rates in Australia 1987–2007, 0–74 years 86 Figure 7–15 Stomach cancer: age-standardised cancer mortality rates in Australia 1987–2007, 0–74 years 92 Figure 7–16 Stomach cancer: age-standardised cancer incidence rates in Australia 1987–2007, 0–74 years 92 Figure 8–1 Australian Government and preventive health structure 99 November, 2013 Figure 8–2 Cancer control implementation process 115 Tables Table 6–1 Mortality: number of observed deaths in Australia in 2007 compared to expected number of deaths based on 1987 rates 32 Table 6–2 Incidence: number of observed new cases in Australia in 2007 compared to expected number of new cases based on 1987 rates 33 Table 7–1 Breast cancer deaths and incident cases in Australia 1987–2007 42 Table 7–2 Breast cancer: average annual percentage change (AAPC) 42 Table 7–3 Cervical cancer deaths and incident cases in Australia 1987–2007 50 Table 7–4 Cervical cancer: average annual percentage change (AAPC) 50 Table 7–5 Colorectal cancer deaths and incident cases in Australia 1987–2007 58 Table 7–6 Colorectal cancer: average annual percentage change (AAPC) 58 Table 7–7 Liver cancer deaths and incident cases in Australia 1987–2007 66 Table 7–8 Liver cancer: average annual percentage change (AAPC) 66 Table 7–9 Lung cancer deaths and incident cases in Australia 1987–2007 72 Table 7–10 Lung cancer: average annual percentage change (AAPC) 72 Table 7–11 Melanoma deaths and incident cases in Australia 1987–2007 80 Table 7–12 Melanoma: average annual percentage change (AAPC) 80 Table 7–13 Prostate cancer deaths and incident cases in Australia 1987–2007 86 Table 7–14 Prostate cancer: average annual percentage change (AAPC) 86 Table 7–15 Stomach cancer deaths and incident cases in Australia 1987–2007 92 Table 7–16 Stomach cancer: average annual percentage change (AAPC) 92 Table 8–1 Key health policies and strategies relating to cancer control 101 Cancer Council NSW • 7 8 • The State of Cancer Control in Australia November, 2013 November, 2013 1 Abbreviations Abbreviations APC Annual percentage change AAPC Average annual percentage change ABS Australian Bureau of Statistics AHMAC Australian Health Ministers Advisory Council AIHW Australian Institute of Health and Welfare BMI Body mass index DoHA Australian Government Department of Health and Ageing DRE Digital rectal examination NPAPH National Partnership Agreement on EPIC European Prospective Investigation into Cancer Preventive Health and Nutrition NPHP National Public Health Partnership FOBT Faecal occult blood test NSIF National Service Improvement Framework HIV - 1 Human immunodeficiency virus 1 NSW New South Wales HPV Human papillomavirus PBS Pharmaceutical Benefits Scheme HRT Hormone replacement therapy PSA Prostate-specific antigen HWA Health Workforce Australia RFA Radiofrequency ablation IARC International Agency for Research on Cancer SES Socioeconomic status MBS Medicare Benefits Scheme UICC Union for International Cancer Control NCD Non-communicable diseases UK United Kingdom NGO Non-government organisation USA United States of America NHMRC National Health and Medical Research Council WHO World Health Organization NHRA National Health Reform Agreement Cancer Council NSW • 9 10 • The State of Cancer Control in Australia November, 2013 November, 2013 2 Report overview Cancer is currently the largest disease burden in Australia and is growing in incidence, primarily due to an ageing population.1-3 The aim of this report is to quantify the changes in cancer incidence and mortality from 1987 to 2007, thus providing a simple summary of the progress over two decades.