Cancer burden and control in Australia: lessons learnt and challenges remaining

Cancer has been a major burden of disease for many decades globally. In Australia, cancer was the leading cause of disease burden in 2011. Despite having successfully implemented a number of cancer control initiatives, Australia continues to have a very high cancer burden. This review article sourced data primarily from the Australian Institute of Health and Welfare and presents an overview of the current cancer burden in Australia with measures of incidence, mortality and survival for all cancers combined, and the disparities in cancer burden by socio-economic disadvantage, geographic remoteness, Indigenous status and country of birth. Comparisons are made between the current situation and that of two to four decades ago, and among different population sub-groups. The data for six selected major cancer types show that in the last three and a half decades (between 1982 and 2017), the age-standardised incidence rate (ASIR) increased for prostate cancer, breast cancer and melanoma of the skin, but decreased for lung cancer and cervical cancer, whereas for colorectal cancer (CRC), it increased and then decreased for males and marginally decreased for females. During the same period, the age-standardised mortality rate was relatively constant for melanoma of the skin and declined for the other five cancers discussed. While there are distinctive factors leading to Australia’s successes in cancer control, some of the reasons for shortfalls are country specific with issues around the health inequities for Indigenous Australians and difficulties in access to health-care due to geographic remoteness. Amongst various shortfalls, the issue of health disparities among different population sub-groups remains a challenge.