Canadian Cancer Statistics 2015 Special topic: Predictions of the future burden of cancer in Canada Produced by Canadian Cancer Society, Statistics Canada, Public Health Agency of Canada, Provincial/Territorial Cancer Registries cancer.ca/statistics Citation Material appearing in this publication may be reproduced or copied without permission. However, the following citation must be used to indicate the source: Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Canadian Cancer Statistics 2015. Toronto, ON: Canadian Cancer Society; 2015. [May 2015] ISSN 0835-2976 This publication is available in English and French on the Canadian Cancer Society’s website at cancer.ca/statistics. The website includes additional resources, such as individual figures from the publication and an archive of previous editions. The development of this publication over the years has benefited considerably from the comments and suggestions of readers. 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Canadian Cancer Society n Canadian Cancer Statistics 2015 2 Members of the Canadian Cancer Statistics Advisory Committee Gillian Bromfield, MSc (Chair) Ryan Woods, MSc Cancer Control Policy, Canadian Cancer Society, Cancer Control Research, BC Cancer Agency, Toronto, Ontario Vancouver, British Columbia Darlene Dale, BASc, FHA Analytic and statistical support Princess Margaret Cancer Registry, Princess Margaret Lin Xie, MSc (Statistics), MSc (MIS) Cancer Centre, Toronto, Ontario Centre for Chronic Disease Prevention, Public Health Prithwish De, PhD Agency of Canada, Ottawa, Ontario Surveillance and Cancer Registry, Cancer Care Alain Demers, PhD Ontario, Toronto, Ontario Centre for Chronic Disease Prevention, Public Health Kim Newman, MA Agency of Canada, Ottawa, Ontario Health Statistics Division, Statistics Canada, Ottawa, Larry Ellison, MSc Ontario Health Statistics Division, Statistics Canada, Ottawa, Rami Rahal, BSc, MBA Ontario System Performance and Surveillance, Canadian The analysts were supported by: Partnership Against Cancer, Toronto, Ontario Robert Semenciw, MSc Amanda Shaw, MSc Formerly – Centre for Chronic Disease Prevention, Centre for Chronic Disease Prevention, Public Health Public Health Agency of Canada, Ottawa, Ontario Agency of Canada, Ottawa, Ontario Review of French translation: Hannah K. Weir, PhD Jean-Marc Daigle, MSc Division of Cancer Prevention and Control, Centers Institut national de santé publique du Québec, Québec, for Disease Control and Prevention, Atlanta, Georgia Québec Canadian Cancer Society n Canadian Cancer Statistics 2015 3 Table of Contents Executive summary . 6 CHAPTER 2 Incidence by sex, age and geography: Who gets About this publication . 8 cancer in Canada? . 29 Purpose and intended audience . 8. Highlights . 29. Format . 8. Introduction . 29. Analysis and production . 8. Incidence by sex . 29. A note on data . .8 Incidence by age . 29. Actual and estimated data . .9 Children, adolescents and young adults . 30. INTRODUCTION Incidence by geographic region . 31. Cancer in Canada . 10 What do these statistics mean? . .33 CHAPTER 1 CHAPTER 3 Incidence: How many people in Canada get Mortality: How many people in Canada cancer? . 16 die of cancer? . 38 Highlights . 16. Highlights . 38. Introduction . 16. Introduction . 38. Probability of developing cancer . 16. Probability of dying from cancer . 38. New cases of cancer in 2015 . .17 Deaths from cancer in 2015 . .39 Trends over time . .18 Trends over time . .40 Trends for selected cancers . 19. Trends for selected cancers . 41. What do these statistics mean? . .22 What do these statistics mean? . .44 Canadian Cancer Society n Canadian Cancer Statistics 2015 4 Table of Contents CHAPTER 4 CHAPTER 6 APPENDIX I Mortality by sex, age and geography: Prevalence: How many people diagnosed with Actual data for new cases and deaths . 107 Who dies of cancer in Canada? . 51 cancer are alive today? . 70 A PPENDIX II Highlights . 51. Highlights . 70. Data sources and methods . 117 Introduction . 51. Introduction . 70. Data sources . .117 Mortality by sex . .51 Tumour-based prevalence . 71. Methods . .118 Mortality by age . 52. Person-based prevalence . 72. Data and methods issues . 124. Cancer deaths among adolescents and What do these statistics mean? . .73 young adults . .52 APPENDIX III CHAPTER 7 Mortality by geographic region . .54 Previous special topics, abbreviations and Special topic: Predictions of the future burden What do these statistics mean? . .55 index . 142 of cancer in Canada . 78 Previous special topics . .142 CHAPTER 5 Highlights . 78. Abbreviations . 143. Relative survival: What is the likelihood of Introduction . 79. Index of tables and figures . .144 surviving cancer? . 60 Projected trends in population . 80. Highlights . 60. Projected trends in cancer incidence counts FOR FURTher infORMATION ............147 Introduction . 60. and rates . .81 Partner organizations . .147 Five-year relative survival . 61. The influence of selected risk factors and Canadian Council of Cancer Registries . 148. Five-year conditional relative survival . .63 interventions on the burden of cancer . .90 Canadian Cancer Society offices . .150 Five-year childhood cancer (0–14 years) survival . .64 Comparisons of projections to other countries . 94. International comparison . 64. What do these statistics mean? . .95 What do these statistics mean? . .64 Canadian Cancer Society n Canadian Cancer Statistics 2015 5 Executive summary Canadian Cancer Statistics is an annual publication that provides estimates of the burden of cancer in Canada for the current year. About 2 in 5 Canadians will develop cancer in their 810,045 lifetime, and about 1 in 4 Canadians will die of cancer. Canadians were alive at In 2015, it is estimated that 196,900 Canadians will the beginning of 2009 2 in 5 develop cancer, and 78,000 will die of cancer. More with a cancer diagnosed Canadians will than half of new cancer cases (51%) will be lung, in the previous develop cancer in breast, colorectal and prostate cancer. Lung cancer is 10 years their lifetime the leading cause of cancer death, causing more cancer deaths among Canadians than the other three major cancer types combined. Despite this large impact, there has been a substantial drop in the lung cancer death rate (especially for men) over the past 25 years, which has driven a decline in the overall cancer death rate. 196,900 Slightly more men than women get cancer in Canada, % Canadians will be diagnosed and the vast majority (89%) of Canadians who develop 63 with cancer in 2015 cancer are over the age of 50. However, cancer can The likelihood, in occur at any age. Its impact at a younger age can be Canada, of surviving at 78,000 least 5 years after a cancer Canadians particularly devastating. According to Statistics diagnosis compared to the will die of cancer Canada, in 2011, cancer was the leading cause of survival of comparable in 2015 disease-related death in children under the age of 15 people in the general years. population Overall, the five-year relative survival ratio for people diagnosed with cancer is 63%, but it ranges widely by the type of cancer. Some cancers have very high 1 in 4 five-year relative survival ratios, including thyroid Canadians will die cancer (98%). Other cancers have consistently low from cancer five-year relative survival ratios, such as pancreatic cancer (8%). Canadian Cancer Society n Canadian Cancer Statistics 2015 6 Executive Summary As of January 2009, 810,045 Canadians had been for highlighting the importance of prevention and diagnosed with cancer within the previous 10 years and planning for additional health resources for managing were still alive on that date. This means that about 2.4% the future burden of cancer in Canada. Despite the of the Canadian population was living with, or beyond, increase in the number of new cases, the age- a cancer diagnosis in the decade leading up to 2009. standardized incidence rate (a measure of cancer risk) This year’s publication also features the future burden is expected to decline somewhat in males (from 465 to of cancer in Canada (Chapter 7: Special topic: 443 per 100,000) but increase in females (from 358 to Predictions of the future burden of cancer in Canada). 371 per 100,000). The chapter is focused on cancer incidence up to 2032 Measuring the cancer burden in Canada is vital for and also considers the impact of changing risk factor health policy, and it helps decision-makers assess the prevalence and the economic impact of selected type and allocation of health resources needed. The interventions. From 2003 to 2007 to 2028 to 2032, the data are also essential in focusing prevention efforts, in average annual Canadian population is predicted to both primary prevention of cancer and secondary grow by 29%, but the proportion of Canadians (65+) is prevention, and allowing more effective treatment of predicted to increase significantly as well, from 13% in certain cancers through earlier detection. Finally, these 2003 to 2007 to 22% in 2028 to 2032. statistics can be useful for prioritizing services to help By 2028 to 2032, the average annual number of new Canadians and their families who have been affected cancer cases is estimated to increase 79% compared to by cancer and who may need supportive care after 2003 to 2007. The increase in the number of new their treatment has ended. We hope that our readers cancer cases is primarily due to the aging Canadian think critically about what these numbers mean and population and, to a lesser extent, population growth how they can be used to improve survival, develop and changes in the risk of developing cancer. The sheer better overall care for those with cancer and reduce number of expected cancer cases is yet another reason cancer incidence in Canada. Canadian Cancer Society n Canadian Cancer Statistics 2015 7 About this publication Canadian Cancer Statistics is part of an annual series • Chapters 1 and 2 describe the incidence of cancer in The Introduction and Chapters 1 to 7 conclude with a that began in 1987.