The concept of cancer control recognises that, while it may not be possible to eradicate cancer, its impact and burden on the community can be reduced. Eight cancers have been targeted in this NHPA - lung cancer, melanoma, non-melanocytic skin cancer, colorectal cancer, non-Hodgkin’s lymphoma, prostate cancer, breast cancer and cancer of the cervix. In 1996 cancer was estimated to be responsible for 19% of the total burden of disease in Australia (AIHW 2000a).
Policy initiatives: cancer screening
Screening is currently considered to be the most effective method of reducing mortality from breast and cervical cancer. The National Program for the Early Detection of Breast Cancer was established in 1991; since 1994 it has been called BreastScreen Australia. The main aim is to detect small cancers in the breast, which are most easily treatable while in their early stages and to reduce mortality and morbidity. The program recommends that women in the target age group (50-69 years) have a mammogram every two years. Women in their forties and seventies also have access to mammography without charge through this program, but are not actively recruited (AIHW 1998).
Although Pap smear tests have been available since the 1960s, the National Cervical Screening Program did not come into effect until 1991. The program seeks to detect the precursors to cancer or abnormalities of cells in the cervix which may lead to invasive cervical cancer. It is estimated that 90% of cervical cancers are potentially preventable (AIHW 1998).
In Budget 2000-01, the Commonwealth Government announced funding for a Bowel (Colorectal) Cancer Screening Pilot. The pilot will assess the feasibility, acceptability and cost-effectiveness of bowel cancer screening. Colorectal cancer is the most common internal cancer affecting both men and women (AIHW 2001a), and accounted for 4,712 deaths in 2000.
Estimates based on information reported in the 2001 NHS show that 311,270 Australians (1.65%) currently had a medically diagnosed neoplasm. Skin cancers were the most commonly reported form of cancer for both males (0.67%) and females (0.33%). Breast cancer was reported by approximately 25,300 women. Overall, males were slightly more likely to report cancer than females.
For females, cancer prevalence peaked in the 45-54 year age group, possibly related to the peak in breast cancer prevalence in this age group. In males, cancer was most prevalent in the 65-74 year age group, reflecting in part the effect of prostate cancer (table 9.11).
The National Cancer Statistics Clearing House, within the AIHW, reported that 80,864 new cases of cancer were diagnosed in 1998. Of these, 43,595 were males and 37,269 were females - an age-standardised cancer incidence rate (age-standardised to the 1991 Australian Population Standard) of 475 for males and 346 for females per 100,000 persons. This equates to a lifetime risk of one in three males and one in four females being directly affected by cancer (AIHW 2001a). This statistic excludes approximately 270,000 annual diagnoses of non-melanocytic skin cancers, which are the most common form of cancer in Australia, but for which data are not collected routinely by cancer registries.
Survival from cancer depends on a number of factors, including whether the cancer is fast or slow growing, its metastatic characteristics, its stage at diagnosis, the availability of appropriate treatment and other co-morbidities. The AIHW estimated that for the period 1992-97, the five-year relative survival rates for cancer were 57% for males and 63% for females (AIHW 2001b).
In 2000, malignant neoplasms (cancer) accounted for 35,628 deaths, which was 28% of all deaths registered. There were 20,153 male deaths and 15,475 female deaths due to cancer. Overall, cancer of the trachea, bronchus and lung was the leading cause of cancer deaths (6,878 deaths), accounting for 19% of all cancer deaths. Among males, the leading causes of cancer deaths were cancer of the trachea, bronchus and lung (23% of all male cancer deaths), prostate cancer (12%) and colon cancer (9%). Among females the leading causes of cancer deaths were breast cancer (16% of all female cancer deaths), cancer of the trachea, bronchus and lung (14%) and colon cancer (10%). Age-specific death rates for cancer increased markedly with age, and were generally greater for males than for females, apart from age groups between 25 and 54 when female deaths from breast cancer tend to occur most frequently.
9.11 CANCER(a) - 2001
|Respiratory and intrathoracic organs|
|Other and sight unknown|
|Benign neoplasms and neoplasms of an uncertain nature|
|All malignant neoplasms|
|(a) Each person may have reported more than one type of condition, and therefore components may not add to totals.|
Source: ABS data available on request, preliminary data from the 2001 National Health Survey.