Cancer incidence and mortality in people aged less than 75 years: Changes in Australia over the period 1987-2007

Background: Australia has one of the highest rates of cancer incidence worldwide and, despite improving survival, cancer continues to be a major public health problem. Our aim was to provide simple summary measures of changes in cancer mortality and incidence in Australia so that progress and areas for improvement in cancer control can be identified. Methods: We used national data on cancer deaths and newly registered cancer cases and compared expected and observed numbers of deaths and cases diagnosed in 2007. The expected numbers were obtained by applying 1987 age-sex specific rates (average of 1986-1988) directly to the 2007 population. The observed numbers of deaths and incident cases were calculated for 2007 (average of 2006-2008). We limited the analyses to people aged less than 75 years. Results: There was a 28% fall in cancer mortality (7827 fewer deaths in 2007 vs. 1987) and a 21% increase in new cancer diagnoses (13,012 more diagnosed cases in 2007). The greatest reductions in deaths were for cancers of the lung in males (-2259), bowel (-1797), breast (-773) and stomach (-577). Other notable falls were for cancers of the prostate (-295), cervix (-242) and non-Hodgkin lymphoma (-240). Only small or no changes occurred in mortality for cancers of the lung (female only), pancreas, brain and related, oesophagus and thyroid, with an increase in liver cancer (267). Cancer types that showed the greatest increase in incident cases were cancers of the prostate (10,245), breast (2736), other cancers (1353), melanoma (1138) and thyroid (1107), while falls were seen for cancers of the lung (-1705), bladder (-1110) and unknown primary (-904). Conclusions: The reduction in mortality indicates that prevention strategies, improvements in cancer treatment, and screening programmes have made significant contributions to cancer control in Australia since 1987. The rise in incidence is partly due to diagnoses being brought forward by technological improvements and increased coverage of screening and early diagnostic testing. (C) 2013 Elsevier Ltd. All rights reserved.