Latest information and statistics on Cancer

Cancer is a disease that causes damage to healthy body cells [24363]. It arises from changes to the genes that control the way cells grow and divide. Healthy cells grow and divide in a controlled way, whereas cancer causes some of the cells of the body to grow and divide in an abnormal way.

Cancer can form almost anywhere in the body, and refers to about 100 different diseases [24363]. The location in the body where the cancer cells begin forming is known as the primary site, and cancer is usually classified by this, for example lung cancer. When cancer cells travel and spread to other parts of the body, it is described as metastasis [24364].

Data sources may use the term ‘neoplasm’ to describe conditions associated with abnormal growth of new tissue, commonly referred to as a tumour. Neoplasms can be benign (not cancerous) or malignant (cancerous) [36771].

Extent of cancer among Aboriginal and Torres Strait Islander people

Incidence and prevalence

In the 2018-19 NATSIHS, 1.3% of Aboriginal and Torres Strait Islander people reported having neoplasms (including both malignant and benign) as a long-term health condition [39231]. For cancer (malignant neoplasms) the proportion was 1.1%. The proportion of males self-reporting cancer was slightly higher than that of females, with percentages of 1.2% and 1.1% respectively. For neoplasms (both malignant and benign) the proportions increased with age; among the 45-54 years age-group the proportion was 2.8% and among the 55 years and over age-group it was 5.3%. When comparing across jurisdictions, the highest proportion of cancer was reported in WA with 1.3%, and when comparing by remoteness, non-remote areas had a higher proportion of cancer (1.3%) reported than remote areas (0.7%).

For 2014-2018, there were 9,262 new cases of cancer diagnosed in Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA and the NT (an average of 1,852 new cases per year) [42101]. The figures were similar for each sex, with 4,646 new cases of cancer in males and 4,616 new cases in females (Table 1). Lung cancer had the highest incidence (15%) of all cancers among Aboriginal and Torres Strait Islander people, with an average of 281 cases diagnosed each year (Derived from [42101]). Prostate cancer accounted for 17% of all cancers diagnosed among males (average of 153 cases diagnosed per year), and among females, breast cancer accounted for 25% of all cancers diagnosed, with an average of 230 cases diagnosed each year.

Table 1. Incidence of all selected and combined cancers for Aboriginal and Torres Strait Islander people by sex, NSW, Vic, Qld, WA and the NT, 2014-2018

Cancer type	Males		Females		Persons
	Number of new cases	Average new cases (per year)	Number of new cases	Average new cases (per year)	Number of new cases	Average new cases (per year)
Colorectal (bowel)	456	91	394	79	850	170
Lung	733	147	671	134	1,404	281
Breast	n/a	n/a	1,150	230	1,150	230
Cervical	n/a	n/a	173	35	173	35
Prostate	765	153	n/a	n/a	765	153
Head and neck	429	86	159	32	588	118
Uterine	n/a	n/a	293	59	293	59
Liver	285	57	104	21	390	78
All cancers combined	4,646	929	4,616	923	9,262	1,852

Notes:

• Incidence of breast and uterine cancers are for females only. Incidence of prostate cancer is for males only.
• n/a – non-applicable.
• All cancers combined include cancer types not listed in the table.

Source:                      AIHW, 2023 [42101]

For 2014-2018, the age-specific incidence rates for all cancers combined increased with age among Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA and the NT [42101]. The cancer type affecting most Aboriginal and Torres Strait Islander people aged 45 years and under, 45-54 years and 55-64 years was breast cancer for females (45 years and under: 12 per 100,000; 45-54 years: 163 per 100,000; 55-64 years: 261 per 100,000). For those aged 65-74 years and 75 years and over, it was prostate cancer for males (65-74 years: 576 per 100,000; 75 years and over: 648 per 100,000).

When comparing jurisdictions (NSW, Vic, Qld, WA and the NT), in 2014-2018 the age-standardised incidence rate for all cancers combined was highest in Vic at 613 per 100,000, followed by Qld at 582 per 100,000, NSW at 511 per 100,000, WA at 422 per 100,000 and the NT had the lowest rate at 400 per 100,000 [42101]. When comparing by remoteness, major cities, inner regional and outer regional locations had higher age-standardised incidence rates for all cancers combined (542, 521 and 519 per 100,000 respectively) than very remote and remote locations (466 and 464 per 100,000 respectively).

Incidence rates for Aboriginal and Torres Strait Islander people are available for some cancer types through monitoring mechanisms for national screening programs. In 2015-2019, there were 167 cases of cervical cancer among Aboriginal and Torres Strait Islander women aged 25-74 years, living in NSW, Vic, Qld, WA, the ACT and the NT, with a crude incidence rate of 19 per 100,000 [48112]. For 2016-2020, in NSW, Vic, Qld, WA, the ACT and the NT, the crude incidence rate of bowel cancer among Aboriginal and Torres Strait Islander people, aged 50-74 years, was 112 per 100,000  [49194]. In 2016-2020, there were 818 new cases of breast cancer diagnosed among Aboriginal and Torres Strait Islander females aged 50-74 years, across NSW, Vic, Qld, WA, the ACT and the NT, with a crude incidence rate of 274 per 100,000 [49861].

Survival

Information on survival from cancer for Aboriginal and Torres Strait Islander people is available for the 10 year period 2009-2018 for NSW, Vic, Qld, WA and the NT [42101]. The approximate relative survival for all cancers combined was 55%; meaning just over half of the people diagnosed with cancer had survived for five years or more after their diagnosis. The five-year approximate relative survival for Aboriginal and Torres Strait Islander males was lower than for females (52% and 58% respectively). The five-year approximate relative survival was highest for bowel cancer (64%) and head and neck cancers (47%) and lowest for lung cancer (13%) and liver cancer (11%) (Table 2).

Table 2. Five-year approximate relative survival (%) for Aboriginal and Torres Strait Islander people by sex, for selected cancers, NSW, Vic, Qld, WA and the NT, 2009-2018

Cancer type	Males	Females	Persons
Colorectal (bowel)	63	64	64
Lung	12	14	13
Breast	n/a	85	n/a
Cervical	n/a	56	n/a
Prostate	94	n/a	n/a
Head and neck	46	50	47
Uterine	n/a	82	n/a
Liver	11	n.p.	11
Bladder	45	42	44
Stomach	23	n.p.	24
All cancers combined	52	58	55

Notes:

• Survival for breast, uterine and cervical cancers are for females only. Survival for prostate cancer is for males only.
• n/a – non-applicable.
• p. – not published (estimate not reliable as there were not enough cases).
• All cancers combined include cancer types not listed in the table.

Source:    AIHW, 2023 [42101]

Crude survival rates are available for the same jurisdictions in the period 2009-2018, which show survival decreased with remoteness [42101]. The five-year crude survival rate for major cities was 54%, while for inner and outer regional locations it was 48% and for remote and very remote locations 39%.

Hospitalisation

In 2022-23, there were 12,570 hospital separations for neoplasms (including all types of cancer), representing 3.5% of all separations (excluding dialysis) among Aboriginal and Torres Strait Islander people (Derived from [41516]). More detailed hospitalisation data for Aboriginal and Torres Strait Islander people are available for 2017-19 [42101]. In this period there were 11,970 hospitalisations for cancer as the principal diagnosis, at a crude rate of 7.2 per 1,000. The rate was higher for males (7.9 per 1,000) than for females (6.5 per 1,000). The age-specific rate of hospitalisations increased with age (except for the 0-4 years age-group at 1.8 per 1,000), with the highest age-specific rate being 51 per 1,000 among the 65 years and over age-group. When comparing crude hospitalisation rates for cancer by jurisdictions, Vic had the highest rate (9.7 per 1,000) followed by SA (9.5 per 1,000), Qld (7.7 per 1,000), Tas (7.0 per 1,000), NSW (6.9 per 1,000), WA (5.9 per 1,000), the ACT (5.7 per 1,000) and the NT (5.5 per 1,000). Most hospitalisations were in outer regional and remote locations (both 7.8 per 1,000), followed by inner regional areas (7.5 per 1,000), major cities (7.0 per 1,000) and very remote locations (5.8 per 1,000).

The numbers of hospitalisations are available for selected cancer types for 2017-19, including: 1,517 (13% of the 11,970 hospitalisations) for cancers of unknown primary site; 1,128 (9.4%) for lung cancer; 720 (6.0%) for bowel cancer; 665 (5.6%) for breast cancer; 542 (4.5%) for prostate cancer (in males); 491 (4.1%) for cancers of the mouth and throat; and 214 (1.8%) for cervical cancer (in females) (Derived from [42101]).

Mortality

In 2018-2022, the age-standardised mortality rate for cancer among Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT was 254 per 100,000 [48392]. When comparing jurisdictions, the mortality rate was highest in Qld and the NT (both 277 per 100,000), followed by WA (260 per 100, 000), NSW (233 per 100,000) and SA (219 per 100, 000).

More detailed information is available for 2015-2019 for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT. The age-standardised mortality rate due to cancer of any type was 230 per 100,000 [44306]. The rate for males (276 per 100,000), was higher than for females (194 per 100,000). The combined total number of deaths for all cancers was 3,576, comprising 1,939 males and 1,637 females.

Table 3 shows numbers of deaths for males and females for selected cancers.

Table 3. Number of deaths for Aboriginal and Torres Strait Islander people by sex, for all cancers combined and selected cancers, NSW, Qld, WA, SA and the NT, 2015-2019

Cancer site/type	Number of deaths – Males	Number of deaths – Females	Total number of deaths
Lung	526	416	942
Breast	6	185	191
Colorectal (bowel)	148	128	276
Prostate	119	n/a	n/a
Head and neck	162	57	219
Melanoma (skin)	19	11	30
Liver	170	97	267
Non-Hodgkin lymphoma	38	28	66
Uterine	n/a	39	n/a
Unknown primary site	126	106	232
Pancreatic	117	123	240
Cervical	n/a	69	n/a
Kidney	32	18	50
Bladder	35	19	54
All cancers combined	1,939	1,637	3,576

Notes:

• Numbers of deaths due to cervical cancer are for females only, and prostate cancer is for males only.
• All cancers combined include cancer types not listed in the table.
• This table only includes deaths due to malignant neoplasms (cancerous tumours) and excludes deaths due to non-malignant neoplasms (in situ tumours, benign tumours and tumours of uncertain or unknown malignancy).
• n/a – non applicable.

Source:    AIHW, 2021 [44306]

In 2023, cancers of the trachea, bronchus and lung combined were the fourth leading cause of death overall for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT, being responsible for 264 deaths [49929]. The crude death rate was 30 per 100,000 (males: 29 per 100,000; females: 30 per 100,000). Age-standardised death rates for other types of cancer in 2023 included cancers of the liver and intrahepatic bile ducts, cancer of the colon (bowel), sigmoid, rectum and anus and pancreatic cancer (all 17 per 100,000), and cancers of the lymphoid, haematopoietic and related tissue (16 per 100,000).

Indigenous identification data for cervical, bowel and breast cancer mortality were collected by cancer databases in NSW, Qld, WA, SA and the NT. In 2017-2021, there were 58 deaths due to cervical cancer among Aboriginal and Torres Strait Islander women aged 25-74 years, with a crude mortality rate of 6.6 per 100,000 women [48112]. In 2018-2022, the  crude mortality rate for bowel cancer among Aboriginal and Torres Strait Islander people aged 50-74 years was 36 per 100,000 [49194]. In 2018-2022, there were 237 deaths due to breast cancer. One hundred and fifty-four (65%) of these deaths were among women aged 50-74 years, with a crude mortality rate of 49 per 100,000 (for this age-group) [49861].

Burden of disease

In 2018, cancer accounted for 9.9% of the total burden of disease among Aboriginal and Torres Strait Islander people [44827]. Of all disease groups, cancer made the fourth highest contribution to total burden. It was the fourth leading cause of disease burden among males (9.8%) and second among females (10%).

Among the top 20 causes of total disease burden, lung cancer was 8^th for males (2.6% of total disease burden) and 11^th for females (2.3% of total disease burden) [44827]. It was the fourth leading cause of burden for those aged 45 to 64 years (4.7% of total disease burden) and the third for those aged 65-74 years (6.5% of total disease burden).