13 December 2021

Good cancer news for most, better for some

Cancer Clinical

Overall cancer rates have gone down and survival rates have improved over the past 30 years, according to the latest Australian Institute of Health and Welfare cancer report – but they still depend on which cancer you get.

Since 1998, the relative five-year survival rate for all cancers combined has jumped from 51% to 70%, and there’s been an improvement for most types.

The five-year survival rate increased by 20% or more for prostate and kidney cancer, multiple myeloma, non-Hodgkin lymphoma and tongue cancer. 

And some cancers that used to be considered difficult to survive, such as stomach cancer and multiple myeloma, are now less threatening. Even brain cancer and mesothelioma saw some improvement, increasing from 11% to 22% and 3% to 6.4%, respectively.

Laryngeal cancer, lip cancer and mesothelioma survival rates stayed about the same. 

Women have fared slightly better than men (71% versus 69%) and 20-39-year-olds have the best odds of all the age groups, with survival rates of 89% at five years. 

But for Aboriginal and Torres Strait Islander people, the five-year approximate relative survival rate for all cancers is only around 54% for people living in major cities, 47% for those in regional areas and 38% in remote areas.

With some cancers, the difference between Indigenous and non-Indigenous survival rates is markedly lower; for instance, 85% for breast cancer compared with 91% in the general population, 63% compared with 70% for colorectal cancer and 58% compared with 73% for cervical cancer, in the major cities. 

Overall Australian cancer rates are down from a peak of 508 cases per 100,000 people in 2008, to around 486 cases per 100,000 people in 2021 (though this doesn’t include BCCs and SCCs, because they are not notifiable diseases anywhere except Tasmania, and the projections are based on data up to 2017 and covid has not been factored in).

Female cancer rates went up from 404 to 441 per 100,000 females, reflecting increasing lung cancer diagnoses for women.

Cancer rates for people aged 40-59 increased more than for any other age group, possibly partly because of higher incidental diagnosis of renal cell carcinoma. Liver and pancreatic cancers also increased significantly since 2001.

Rates also went up for 20-39-year-olds and for people under 20. While melanoma went from being one of the most common cancers in the younger set to accounting for just 2% of all cancers in that age group, colorectal cancer ratesmore than doubled.

A few of the 10 most common cancers, which account for 71% of all cancer diagnoses, have seen decreased rates. Prostate cancer, lung cancer and colorectal cancer all became less common over the study period.

But most  other cancers have increased in incidence over the past 20 years. Breast cancer has gone up from 61.9 in 2001 to 67.8 in 2021, melanoma 46.7 to 55.3, non-Hodgkin lymphoma 17.9 to 20.4, kidney cancer 10.8 to 14.4 and uterine cancer 8.0 to 10.5.

Their order has been shuffled too. Colorectal was the most common cancer in 2001 and is now fourth after breast, prostate and melanoma cancers. 

Smoking is still the biggest contributor to cancer burden of disease, responsible for 21% of the estimated 881,094 disability-adjusted life years attributed to cancer.

Lung cancer accounts for most of these (65%), but smoking also contributes to oesophageal, pancreatic, liver, colorectal, lip and oral cavity, bladder, breast, stomach, kidney, laryngeal, prostate, nasopharyngeal and cervical cancers, and leukaemia.

Given the overall higher likelihood of surviving cancer, the report’s authors noted, it is important to address the financial, social, psychological and physical challenges that cancer survivors continue to face.

“These factors, and the associated stressors and reduced quality of life for cancer survivors and their family, friends and caregivers, highlight the importance of follow-up health care and of survivorship as part of the cancer-control continuum,” they said.

AIWH 2021, online 1 December

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