Cancer in NSW: Incidence and Mortality 2008
Cancer in New South Wales: Incidence and Mortality 2008 is the most up-to-date overview of cancer published for NSW. The report provides new information for incidence, mortality and survival from cancer in NSW.
Cancer is a major public health problem in NSW and Australia and
many parts of the world. If a person lives to 85 years of age there
is a one is two chance that they will have a diagnosis of cancer in
their lifetime if they are male and a one in three chance if they
are female. The absolute number of cases of cancer is increasing as
our population ages and grows, and because of the lifestyle choices
we make.
The number of men and women diagnosed with cancer has increased
to 36,611 new cases. Incidence rates have increased in men by 11
per cent over the past 10 years.
There is a significant downward trend in incidence rates of
cancer in women for the most recent seven-year period. This
downward trend in incidence observed in NSW is consistent with
findings in the USA.
Prostate cancer, our most common cancer overall, increased from
18 per cent in 2007 to 19 percent of total cancers in 2008 or 33
per cent of all cancers in men. The lifetime risk of prostate
cancer is now one in four if a man lives to the age of 85 years.
The most recent five year survival is 90 per cent for males
diagnosed between 2002 and 2006 and followed to the end of
2007.
Australia has the highest rates of melanoma in the world and
this has continued to increase over the last 10 years by 15 per
cent in males and 11 per cent in females. Most of the increase in
melanoma is seen in older people with no increases in those aged
less than fifty years.
Mortality rates from all causes of cancer death have declined in
NSW since 1989 in males and females. In the last ten years
mortality rates declined by 13.2 per cent in males and 7.8 per cent
in females. Cancer is still responsible for 28 per cent of all
deaths in NSW and is the leading cause in people aged between 35
and 84 years in 2008.
The absolute number of cases of cancer is
increasing as our population ages and grows, and because of the
lifestyle choices we make.
There has been a more rapid decline in mortality rates in NSW
since 2005 in males and 2004 in females. The decline in overall
mortality rates in males is most influenced by declines in lung,
bowel and prostate cancer mortality rates.
The most likely explanation for more rapid reduction in
mortality rates in NSW in women since 2004 is the decline in breast
and bowel cancer mortality rates. Unfortunately, lung cancer and
pancreatic cancer mortality rates continue to increase in women.
Reductions in mortality rates for the majority of cancer sites are
considered to result from a combination of earlier detection,
changes in risk factors and improved treatments.
Of concern is the statistically significant 11 per cent increase
in male mortality rates from melanoma for the most recent ten year
period. This is the first time a statistically significant increase
in mortality from melanoma is reported in NSW. Increasing mortality
from melanoma has also been reported in the USA, UK, Canada and
Nordic countries. Melanoma is treatable if diagnosed early.
Mortality rates also continue to increase for liver cancer in
males.
Overall, the cancer survival in NSW are as good as or better
than anywhere in the world. Around 65 percent of people diagnosed
with cancer in NSW are alive five years later. It is particularly
pleasing that survival has increased by two percent for males from
61 per cent to 63 since the last time survival was measured between
1999 and 2003 and has remained at 66 per cent for women.
Cancers with 80 per cent or better survival five years after the
diagnosis include prostate, breast, melanoma and lymphoma.
The most prevalent cancer with a five year survival of between
30 per cent and 70 per cent is bowel cancer. Bowel cancer survival
will be expected to improve as bowel cancer screening becomes more
established, given the evidence from large Australian pilot studies
and the success of established screening programs like breast and
cervical cancer.
Cancers with 20 per cent or worse survival at five years include
lung cancer, brain, oesophagus, liver and pancreas cancers and
mesothelioma. Cancers with less than 20 per cent survival five
years after a diagnosis require additional focus, new research and
better methods of early diagnosis as well as a better understanding
of the molecular nature of the cancer leading to more specific and
targeted therapies.
New cases of cancer in NSW for 2008
New cases in 2008, excludes non-melanoma (basal and
squamous cell) skin cancers, which are estimated to account for
154,693 cases in 2008.
| All people |
36,611 |
| Males |
20,873 |
| Females |
15,738 |
Most common cancers in NSW for 2008
All people
| Rank |
Type |
Cases |
% of total |
| 1. |
Prostate |
6,905 |
19% |
| 2. |
Bowel |
4,741 |
13% |
| 3. |
Breast |
4,418 |
12% |
| 4. |
Melanoma |
3,591 |
10% |
| 5. |
Lung |
3,260 |
9% |
Males
| Rank |
Type |
Cases |
% of total |
| 1. |
Prostate |
6,905 |
33% |
| 2. |
Bowel |
2,606 |
12% |
| 3. |
Melanoma |
2,127 |
10% |
| 4. |
Lung |
1,906 |
9% |
| 5. |
NHL |
758 |
4% |
Females
| Rank |
Type |
Cases |
% of total |
| 1. |
Breast |
4,376 |
28% |
| 2. |
Bowel |
2,135 |
14% |
| 3. |
Melanoma |
1,464 |
9% |
| 4. |
Lung |
1,354 |
9% |
| 5. |
NHL |
633 |
4% |
- 36,611 people (20,873 males and 15,738 females) were diagnosed
with invasive cancer in NSW.
- Cancers of the prostate, bowel, breast, melanoma and lung
cancer were the most common and were responsible for 63 per cent of
all new cancers.
- Males were 1.5 times more likely to be diagnosed with cancer
than females.
- Prostate cancer as a proportion of all cancer increased by 1
per cent compared to 2007.
- Bowel cancer as a proportion of all cancer declined by 1 per
cent compared with 2007.
- There were 300 additional cases of prostate cancer in 2008
compared with 2007.
- Breast and lung cancer in females increased by 1 per cent
compared to the proportional representation in 2007.
Figure 1: New cases of cancer in persons, NSW,
2008
 |
Melanoma refers to melanoma of the skin only.
Cancers of the colon and rectum are presented separately to allow
comparison with other epidemiological publications and also
presented together as bowel cancer.
|
Cancer deaths in 2008
Total deaths caused by cancer in NSW for 2008
|
All people:
|
13,213
|
|
Males:
|
7,391
|
|
Females:
|
5,822
|
- There were 14 fewer cancer deaths than reported in 2007.
- Cancer represented 28 per cent of all NSW deaths and 29 per
cent of all deaths in Australia1 in 2008.
- Cancer was the leading cause of death in NSW people aged 35 to
84 years.
- The top five cancers caused 53 per cent of all cancer deaths in
2008.
- Lung cancer as a proportion of total cancer deaths increased by
2 per cent compared to 2007.
Most common causes of cancer deaths in 2008
All people
|
Rank
|
Type
|
Deaths
|
% of total
|
|
1.
|
Lung:
|
2,664
|
20%
|
|
2.
|
Bowel:
|
1,716
|
13%
|
|
3.
|
Prostate:
|
930
|
7%
|
|
4.
|
Breast:
|
909
|
7%
|
|
5.
|
Pancreas:
|
749
|
6%
|
Males
|
Rank
|
Type
|
Deaths
|
% of total
|
|
1.
|
Lung
|
1,666
|
23%
|
|
2.
|
Bowel:
|
935
|
13%
|
|
3.
|
Prostate:
|
930
|
13%
|
|
4.
|
Pancreas:
|
381
|
5%
|
|
5.
|
CUP:
|
364
|
5%
|
Females
|
Rank
|
Type
|
Deaths
|
% of total
|
|
1.
|
Lung:
|
998
|
17%
|
|
2.
|
Breast:
|
904
|
16%
|
|
3.
|
Bowel:
|
781
|
13%
|
|
4.
|
CUP1:
|
384
|
7%
|
|
5.
|
Pancreas:
|
368
|
6%
|
Figure 2: Cancer deaths in persons, NSW, 2008
 |
Differences by age
New cases by age group in 2008
|
Age Group
|
New cases
|
% of total
|
|
less than 15 years:
|
172
|
0.5%
|
|
15 to 29 years:
|
555
|
1.5%
|
|
30 to 64 years:
|
14,928
|
40.8%
|
|
65 years and older
|
20,956
|
57.2%
|
- The risk or likelihood of being diagnosed with cancer increases
with age.
- 70 per cent of lung cancers, 66 per cent of bowel cancers, 63
per cent of prostate cancers and 38 per cent of breast cancers were
diagnosed in people aged 65 years and older.
- 49 per cent of all melanomas were found in males and females
aged 30 years to 64 years.
- The majority of female breast cancer cases (2,247 or 51 per
cent) were aged between the BreastScreen target age range of 50 and
69 years of age at diagnosis.
Trends
Figure 3: Trends in overall cancer incidence 1999 to
2008
 |
- Prostate cancer is responsible for a third of all new cases in
males (33 per cent), therefore changes in the rates of all cancer
in males will be most influenced by changes in prostate cancer
rates.
- Rates for all cancer in males were also influenced by changes
in rates of the high volume cancers of bowel, melanoma and lung.
Bowel cancer incidence rates have remained stable, melanoma rates
have continued to increase and lung cancer rates continued to
decrease.
- There was no statistically significant change in female cancer
incidence rates over the 10 year period. However, there was a
significant decline in incidence rates for the most recent seven
year period.
- Incidence rates were stable for breast and bowel cancer in
females.
- Lung, melanoma, liver and thyroid cancer in females
increased.
- Head and neck, oesophagus, stomach and cervix cancer rates in
females declined.
- Compared with the previous 10-year period the percentage change
in incidence rates of pancreatic cancer is no longer statistically
significant.
Figure 4: Trends in overall cancer mortality 1999 to
2008
 |
- During the period 1999 to 2008 age standardised mortality rates
for all cancers declined by 13.2 per cent in males and 7.8 per cent
in females . The rate of decline in mortality rates is steeper from
2005 in males and 2004 in females.
- Mortality rates declined for the majority of cancer sites
including bowel cancers, non-Hodgkin's lymphoma, head and neck
cancers, leukaemia and cancer of unknown primary (CUP).
- Mortality rates increased for liver cancer (males and females),
pancreatic cancer and melanoma in males and lung cancer in
females.
- All other mortality rate differences were similar in the 1999
to 2008 period to those reported in the previous ten year
period.
Survival in NSW
Figure 5: Survival in NSW
 |
- Five-year relative survival from cancer in NSW improved to 65
per cent in 2002 - 2006, from 63 per cent in 1999 - 2003.
- Relative survival for males increased to 63 per cent from 61
percent and survival in females remained at 66 per cent.
- For males diagnosed with prostate cancer, the five-year
relative survival was 90 per cent up from 88 per cent.
- The five-year relative survival was 65 per cent for males and
66 per cent for females diagnosed with bowel cancer.
- For females diagnosed with breast cancer, the five-year
relative survival was 88 per cent in both periods.
- The five-year relative survival was 89 per cent for males and
93 per cent for females diagnosed with melanoma in both
periods.
- Survival five-years after diagnosis exceeded 80 per cent for
cancers of the uterus, and was greater than 95 per cent for cancers
of the thyroid, testis, and lip.
- Five-year relative survival was less than 22 per cent for,
stomach lung and brain cancer; and less than 10 per cent for the
poor prognosis cancers of mesothelioma and pancreatic cancer.
- Once confidence limits were considered there was a
statistically significantly higher survival from all cancer and
cancer unknown primary.
- Bladder cancer survival was statistically significantly lower
in males compared to the earlier period 1999-2003.
- All other cancer sites were not statistically significantly
different between the two time periods.
- Survival was significantly higher in females than males for
most cancer sites.
Key Findings
Incidence
- Incidence rates in males increased by 11 per cent for the most
recent 10-year period but declined in females for the most recent
seven-year period.
- Prostate cancer increased as a proportion of total cancers from
18 per cent in 2007 to 19 per cent in 2008 and for males from 32
per cent to 33 percent for the same time period.
- Lung cancer incidence rates in females continue to increase at
a more rapid rate with a 29 per cent increase compared with a 23
per cent increase for the previous 10 year period.
- Uterine cancer incidence rates increased by 19 per cent
compared to 17 per cent in the previous 10 year period.
- In all people, incidence rates for head and neck cancer fell by
10 per cent and mortality rates fell by 23 per cent.
- Pancreatic cancer incidence in all people and mortality rates
in males continue to increase. As survival is poor for pancreatic
cancer trends in incidence and mortality rate mirror one
another.
Mortality
- Lung cancer was responsible for 23 per cent of deaths in males
in 2008 accounting for an increase in the proportion of total
cancer deaths in males from 21 per cent in 2007. Mortality rates in
males have been declining since the 1980s. However, the rate of the
decline has slowed in the last four years.
- Death rates in males and females have declined since 1989 but
have dropped more steeply from 2005 and 2004 respectively to
2008.
- Mortality rate declines in females for all cancer are most
influenced by changes in breast cancer mortality rates.
- Mortality rates for melanoma in males increased for the first
time by 12 percent in the most recent ten year period.
- Cervical cancer mortality rates increased in 2008. This
increase is mainly in females aged 80 years and older and those
aged 50 to 55 years compared to earlier time periods. Investigation
by country of birth group shows similar patterns over time,
indicating that the increase in death rates is not related to a
particular migrant group. Further monitoring of mortality is
required to determine the significance of this change.
Survival
- Five-year relative survival was 64% in 2002-2006, compared to
63% in 1999-2003. This was a statistically significant
improvement.
- Survival increased in males from 61 per cent to 63 per cent and
remained higher in females at 66 per cent.
Related information:
This report contains the most up to date cancer data for NSW.
Projections of cancer incidence and mortality are provided in
the Cancer
incidence and mortality projections 2011-2021 report.
