CANCER WITHIN AUSTRALIA'S LEADING CAUSES OF DEATH

Cancer (C00-C97, D45-D46, D47.1 and D47.3-D47.5) accounted for 46,003 or 28.9% of all deaths in Australia in 2015. There are many types of cancers, all characterised by the presence of abnormal cells within the body (cancerous cells) which have the ability to multiply and invade tissue surrounding the site of the tumour and spread to other parts of the body (Cancer Australia).

In 2015 there were seven cancers in the 20 leading causes of death. Lung cancer was the fourth leading cause of death overall and accounted for the most cancer deaths (8,466). Colon cancer ranked as the seventh leading cause overall and was the second most common cancer causing death (4,433). For important additional information on colon cancer see the article: Complexities in the Measurement of Bowel Cancer in Australia. Other cancer types that appeared in the top 20 included blood and lymph cancers, prostate, breast, pancreatic and skin cancers (melanoma and non-melanoma types).

The graph below shows the standardised death rates for the five most common cancers over the past decade. While the number of deaths from these cancers has increased over the past 10 years, standardised death rates for all have declined, with lung cancer showing the largest decline from 34.0 deaths per 100,000 in 2006 to 30.5 in 2015. Tobacco smoking is a key risk factor for lung cancer (Cancer Australia). While changes in patterns of tobacco use do not immediately influence mortality rates, the ABS Australian Health Survey has found that the proportion of adults (over 18 years of age) who smoked on a daily basis decreased from 22.4% in 2001 to 14.5% in 2014-15.

CANCER DEATHS BY AGE GROUPS AND SEX

Cancer deaths: Males and females

Lung cancer was the leading cause of cancer deaths for both males and females in 2015. Lung cancer was also the second leading cause of death overall for males, while it was ranked fifth for females. The standardised death rate from lung cancer for males was 38.9 deaths per 100,000 males, considerably higher than that for females (23.5 deaths per 100,000 females). According to the 2014-15 Australian Health Survey, a higher proportion of males smoked tobacco on a daily basis (16.9%) than females (12.1%).

The second leading cause of cancer deaths among males was prostate cancer, while for females it was breast cancer. A further insight into the effect of these cancers can be gained from measures such as median age at death and years of potential life lost (a measure of premature mortality). In 2015, the median age at death for prostate cancer was 82.4 years and it accounted for 8,174 years of potential years of life lost for males. This compared to breast cancer which had a younger median age at death of 70.6, and as a result accounted for a much higher 30,869 years of potential life lost for females.

Cancer deaths: Age structure

Age is clearly an important factor when considering cancer mortality. The graph below shows the number of deaths from all cancers in 2015 by five year age groups. The median age for all cancer deaths was 75.6, and approximately two thirds of these deaths occurred in persons between the ages of 60 and 89. The graph also shows the higher incidence of cancer mortality among males compared to females between the ages of 50 and 89, while the incidence among females is higher for people 30 to 49 years of age, and those aged 90 and over.

Different age groups are more likely to be affected by specific types of cancers. Among females 30 to 49 years of age there were 292 deaths from breast cancer out of a total of 1,119 cancer deaths (26.1%). Breast cancer has one of the lower median ages at death among all cancer types, and this in part accounts for the higher number of female deaths compared to males in these younger age groups.

Deaths from cancers among children aged 0-14 are rare. In 2015, there were 94 children who died from cancer. Blood and lymph cancers (especially leukaemias) accounted for 34 deaths, while cancers of the central nervous system (especially brain cancers) accounted for 29 deaths. Mortality rates for childhood cancers have decreased over time, with survival rates increasing from 68% in 1989 to 83% in 2011 (Cancer Australia).

CANCER MORTALITY AND CANCER INCIDENCE IN AUSTRALIA

Recent burden of disease analysis, which provides a means of comparing the impact of different diseases, has found cancer to be the disease group which causes the most burden in Australia (AIHW). Information on cancer mortality is a critically important factor for understanding and monitoring the impact of these diseases over time. However, it does not necessarily reflect the complex interactions between risk factors, screening programs, diagnosis and treatments that are key focal points in the ongoing fight to prevent cancer deaths.

The table below shows the top five cancers by incidence (2016 expected counts, Cancer Australia), alongside the top five by numbers of deaths in 2015. Prostate, colon and breast cancer have the highest incidence rates, while lung, colon and blood and lymph cancers have the highest mortality rates. Over time, changes in patterns of mortality can highlight how screening programs, public health messages and awareness campaigns, advances in disease understanding and advances in treatments can increase survivability and reduce mortality rates from the many different types of cancers.

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2.4 ESTIMATED CANCER INCIDENCES FOR 2016 AND LEADING CANCER DEATHS IN 2015, Australia
Cancer Incidence 2016 Expected Counts	No.	Cancer Deaths 2015	No.
Prostate	18 138	Lung (C33-C34)	8 466
Colon	17 520	Colon (C18-C21, C26.0)	5 543
Breast	16 084	Blood and lymph (C81-C96)	4 412
Melanoma	13 283	Prostate (C61)	3 195
Lung	12 203	Breast (C50)	2 967
(a) Causes of death data for 2015 are preliminary and subject to a revisions process. See Explanatory Notes 52-55 and A More Timely Annual Collection: Changes to ABS Processes (Technical Note) in this publication.