CANCER SERIES Number 64 Lung cancer in Australia An overview November 2011 Australian Institute of Health and Welfare Canberra Cat. no. CAN 58 The Australian Institute of Health and Welfare is a major national agency which provides reliable, regular and relevant information and statistics on Australia’s health and welfare. The Institute’s mission is authoritative information and statistics to promote better health and wellbeing. Cancer Australia is the Australian Government’s national cancer agency. Cancer Australia was established to benefit all Australians who are affected by cancer, their families and carers. Cancer Australia works to reduce the impact of cancer and improve the wellbeing of those diagnosed by ensuring that evidence informs cancer prevention, screening, diagnosis, treatment and supportive care. © Australian Institute of Health and Welfare 2011 This product, excluding the AIHW logo, Commonwealth Coat of Arms and any material owned by a third party or protected by a trademark, has been released under a Creative Commons BY 3.0 (CC-BY 3.0) licence. Excluded material owned by third parties may include, for example, design and layout, images obtained under licence from third parties and signatures. We have made all reasonable efforts to identify and label material owned by third parties. You may distribute, remix and build upon this work. However, you must attribute the AIHW as the copyright holder of the work in compliance with our attribution policy available at <www.aihw.gov.au/copyright/>. The full terms and conditions of this licence are available at <http://creativecommons.org/licenses/by/3.0/au/>. Enquiries relating to copyright should be addressed to the Head of the Communications, Media and Marketing Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601. This publication is part of the Australian Institute of Health and Welfare’s Cancer series. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>. ISBN 978-1-74249-222-3 Suggested citation Australian Institute of Health and Welfare & Cancer Australia 2011. Lung cancer in Australia: an overview. Cancer series no. 64. Cat. no. CAN 58. Canberra: AIHW. Australian Institute of Health and Welfare Cancer Australia Board Chair Advisory Council Chair Dr Andrew Refshauge Dr William Glasson AO Director Chief Executive Officer David Kalisch Dr Helen Zorbas Any enquiries about or comments on this publication should be directed to: Communications, Media and Marketing Unit Australian Institute of Health and Welfare GPO Box 570 Canberra ACT 2601 Tel: (02) 6244 1032 Email: [email protected] Published by the Australian Institute of Health and Welfare Printed by Instant Colour Press Please note that there is the potential for minor revisions of data in this report. Please check the online version at <www.aihw.gov.au> for any amendments. Foreword Lung cancer in Australia: an overview is the first tumour-specific report including cancer registry data in a series of collaborations between Cancer Australia and the Australian Institute of Health and Welfare. It is aimed at documenting key cancer statistics to provide the research and health service sectors with relevant data to reduce the impact of cancer in Australia. This report provides, for the first time, a comprehensive summary of national statistics on lung cancer in Australia. Lung cancer is the leading cause of cancer death in Australia and represents the fourth most commonly diagnosed cancer. While the incidence rate for lung cancer in men has been decreasing, there has been a marked increase in the incidence rate in females. Similarly, while 5-year relative survival from lung cancer has increased for both sexes, survival from this disease remains low. This report identifies the relationship between lung cancer incidence and mortality and geographical remoteness, socioeconomic status, Aboriginal and Torres Strait Islander status, and country of birth. In addition, information on survival, prevalence, hospitalisations, and the burden of disease from lung cancer contextualises the impact of this cancer on our population and health system. This report highlights the significant burden of disease that lung cancer places on our community and underscores the concerted action required across the research and health service sectors to improve lung cancer outcomes in Australia. The Commonwealth Government is funding a program of work in lung cancer through its national cancer agency, Cancer Australia. This work will build the evidence base for clinical best practice, fund research, and support the implementation of coordinated care to improve survival. Cancer Australia’s lung cancer initiatives are an important step in addressing the impact of lung cancer on our community and this report provides the platform for monitoring trends and assessing changes in the impact of lung cancer in the future. The Australian Institute of Health and Welfare’s work informs and supports the development of policy and programs on Australia’s health and welfare through the provision of relevant, timely and high-quality information. The Institute collaborates with the Commonwealth and state and territory governments and non-government organisations in undertaking its mission. David Kalisch Dr Helen Zorbas Professor David Roder Director CEO Senior Population Health Advisor Australian Institute of Cancer Australia Cancer Australia Health and Welfare iii Contents Acknowledgments........................................................................................................................... viii Abbreviations ...................................................................................................................................... ix Symbols ................................................................................................................................................ xi Summary ............................................................................................................................................. xii 1 Introduction .................................................................................................................................... 1 What is lung cancer? ...................................................................................................................... 1 What are the different types of lung cancer? .............................................................................. 2 Lung cancer in a policy context .................................................................................................... 3 Purpose and structure of this report............................................................................................ 3 Data interpretation ......................................................................................................................... 4 Data sources .................................................................................................................................... 5 2 Risk factors for lung cancer ......................................................................................................... 6 Introduction .................................................................................................................................... 7 Lifestyle factors ............................................................................................................................... 7 Environmental factors ................................................................................................................... 9 Biomedical factors ........................................................................................................................ 10 3 Incidence of lung cancer ............................................................................................................ 11 Introduction .................................................................................................................................. 12 How many people were newly diagnosed with lung cancer in 2007? ................................. 12 Has the occurrence of lung cancer changed over time?.......................................................... 14 What is the risk of being diagnosed with lung cancer? .......................................................... 17 What is the average age at diagnosis? ....................................................................................... 17 How many people are expected to be diagnosed with cancer in 2010? ............................... 18 What are the most common types of lung cancer? .................................................................. 19 Does incidence differ by stage? .................................................................................................. 25 Do incidence rates differ across population groups? .............................................................. 27 How does Australia compare internationally? ........................................................................ 34 4 Mortality from lung cancer ........................................................................................................ 37 Introduction .................................................................................................................................. 38 How many people died from lung cancer in 2007? ................................................................. 38 Have lung cancer mortality rates changed over