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Cancer in Aboriginal and Torres Strait Islander people of Australia

The following information incorporates the most up-to-date data available to describe the incidence, mortality, survival and prevalence of cancer in Aboriginal and Torres Strait Islander people of Australia. The ICD-10 cancer codes associated with ‘all cancers combined’ and individual cancer sites can be found on their respective pages.

The main data sources for this web page are the 2013 Australian Cancer Database (ACD) and the 2014 National Mortality Database (NMD). The 5-year periods of incidence data (2008 to 2012) and mortality data (2010 to 2014) were used due the availability of actual data.


Number of new cancer cases diagnosed in Indigenous Australians, 2008–2012

5,946 = Male icon PNG 2,899 males + Female icon PNG 3,047 females


Number of deaths from cancer in Indigenous Australians, 2010–2014

2,558 = Male icon PNG 1,324 males + Female icon PNG 1,234 females


44-in-100

Chance of surviving at least 5 years (2009–2013)

44%


crowd

Indigenous Australians living with cancer at the end of 2012 (diagnosed in the 5 year period 2008 to 2012)

3,337


Key findings

The age-standardised incidence rate and mortality rate for all cancers combined is higher for Indigenous Australians than non-Indigenous Australians. The higher incidence rate may be related to high prevalence of cancer-related modifiable risk factors such as smoking, alcohol consumption and Hepatitis B infection, along with lower participation in cancer screening in Indigenous Australians. The higher mortality rate may be partly due to the fact that Indigenous Australians generally have poorer access to health-care services and are more likely to have cancers that are diagnosed at a later stage than non-Indigenous Australians. [1, 2]

New cases of cancer in Aboriginal and Torres Strait Islander people of Australia

Reliable national data on the diagnosis of cancer for Indigenous Australians are not available. All state and territory cancer registries collect information on Indigenous status; however, in some jurisdictions the quality of Indigenous status data is insufficient for analyses. Information in the ACD on Indigenous status is considered to be of sufficient completeness for reporting for New South Wales, Victoria, Queensland, Western Australia and the Northern Territory. Data for these five jurisdictions were used to examine the incidence of cancer by Indigenous status.

In 2008–2012, there were 5,946 new cases of cancer diagnosed in Indigenous Australians (2,899 males and 3,047 females) in New South Wales, Victoria, Queensland, Western Australia and the Northern Territory. During the same period, 454,755 new cases of cancer were diagnosed in non-Indigenous Australians in the same 5 jurisdictions.

In 2008–2012, the age-standardised incidence rate for Indigenous Australians was 484 cases per 100,000 persons (547 for males and 439 for females). The age-standardised incidence rate for non-Indigenous Australians during the same period was 439 cases per 100,000 persons (525 for males and 368 for females).

In 2008–2012, age-specific incidence rate from cancer were higher for Indigenous Australians for age groups 40–44 to 75 years and older. The age-specific incidence rate was higher in non-Indigenous Australians in all other age groups (Figure 1).

In 2008–2012, the risk of an Indigenous Australian being diagnosed with cancer by their 75th birthday was 1 in 3 (1 in 3 for males and 1 in 3 for females). Similarly, the risk of a non-Indigenous Australian being diagnosed with cancer by their 75th birthday was 1 in 3 (1 in 3 for males and 1 in 4 for females).

During 2008–2012, the 10 most commonly diagnosed cancers among Indigenous Australians accounted for approximately 69% of all cancers diagnosed within this population. Seven of the ten most diagnosed cancers were common to both Indigenous and non-Indigenous Australians. However, the top 10 cancer incidence rankings for Indigenous Australians differed from those for non-indigenous Australians (Table 1). Cancer types that were ranked higher in the Indigenous population than in the non-Indigenous population include:

  • Lung cancer (ranked 1st compared with 4th)
  • Liver cancer (ranked 6th compared with 17th)
  • Uterine cancer (ranked 8th compared with 14th).

Conversely, the incidence of prostate cancer was ranked higher in non-Indigenous Australians than in Indigenous Australians.

Table 1: The 10 most commonly diagnosed cancers in Aboriginal and Torres Strait Islander people of Australia, New South Wales, Victoria, Queensland, Western Australia and the Northern Territory, 2008–2012.
Cancer site (ICD-10 code) Indigenous Australians Non-Indigenous Australians
Number of new cases Rank ASR Number of new cases Rank ASR
Lung (C33-34) 864 1 81.8 43,343 4 41.4
Breast (C50) 716 2 94.2 57,796 3 109.7
Colorectal (C18-20) 579 3 51.7 59,040 2 56.8
Prostate (C61) 504 4 105.7 79,046 1 156.5
Head and neck
(C00-14,C30-32)
406 5 28.5 14,965 7 14.5
Liver (C22) 208 6 16.9 6,216 17 6.0
Lymphoma (C81-86) 208 7 16.1 20,156 6 19.7
Uterus (C54-55) 206 8 28.4 8,933 14 16.4
Leukaemia (C91-95) 194 9 12.1 12,283 8 12.1
Unknown primary site (C77-C80,C97) 191 10 18.2 9,784 12 9.4

Notes

  1. Breast and Uterine cancer age-standardised rates are expressed per 100,000 females.
  2. Prostate cancer age-standardised rates are expressed per 100,000 males.

Figure 1: Age-specific incidence rates for cancer in Indigenous and non-Indigenous Australians, New South Wales, Victoria, Queensland, Western Australia and the Northern Territory, 2008–2012

indigenous-cancers-fig1

Source: AIHW analysis of the Australian Cancer Database, (see source table 1).

Deaths from cancer in Aboriginal and Torres Strait Islander people of Australia

Information in the NMD on Indigenous status from 2010 to 2014 is considered to be of sufficient quality for use for five jurisdictions: New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Data for these five jurisdictions are used to examine mortality of cancer by indigenous status.

In 2010–2014, there were 2,558 deaths from cancer among Indigenous Australians (1,324 males and 1,234 females) in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. During the same period, there were 151,635 deaths from cancer among non-Indigenous Australians (86,396 males and 65,239 females).

In 2010–2014, the age-standardised mortality rate among Indigenous Australians was 221 deaths per 100,000 persons (253 for males and 197 for females). During the same period, the age-standardised mortality rate was 171 deaths per 100,000 persons for non-Indigenous Australians (213 for males and 137 for females).

In 2010–2014, age-specific mortality rates from cancer were higher for Indigenous Australians for age groups 35–39 to 70–74. The age-specific mortality rate was generally higher in non-Indigenous Australians in other age groups (Figure 2).

In 2010–2014, the risk of an Indigenous Australian dying from cancer by their 75th birthday was 1 in 7 (1 in 6 for males and 1 in 8 for females). The risk of a non-Indigenous Australian dying from cancer by their 75th birthday was 1 in 10 (1 in 9 for males and 1 in 10 for females).

During 2010–2014, the 10 most common causes of cancer deaths among Indigenous Australians accounted for approximately 74% of all cancers deaths in this population. Lung cancer was the most common cancer death for both Indigenous and non-Indigenous Australians. Similarly, seven cancer types were in the top 10 mortality rankings for both Indigenous and non-Indigenous Australians. However, the order of the cancer mortality rankings differed between Indigenous and non-Indigenous Australians (Table 2). Cancer types that were ranked higher in the Indigenous population include:

  • Head and neck cancer (ranked 2nd compared with 16th)
  • Liver cancer (ranked 3rd compared with 9th)
  • Oesophageal cancer (ranked 8th compared with 13th)
  • Stomach cancer (ranked 10th compared with 14th).

Conversely, colorectal cancer and prostate cancer were ranked higher among non-Indigenous Australians than in Indigenous Australians.

Table 2: The 10 most common cancer deaths in Aboriginal and Torres Strait Islander people of Australia, New South Wales, Queensland, Western Australia, South Australia and the Northern Territory, 2010–2014.
Cancer site (ICD-10 code) Indigenous Australians Non-Indigenous Australians
Number of deaths Rank ASR Number of deaths Rank ASR
Lung (C33-34) 670 1 57.7 28,769 1 32.2
Head and neck
(C00-14,C30-32)
190 2 13.9 3,587 16 4.0
Liver (C22) 177 3 14.5 5,247 9 5.9
Unknown primary site
(C77-80,C97)
173 4 16.9 9,420 5 10.6
Breast (C50) 154 5 22.2 9,783 4 21.1
Pancreas (C25) 136 6 12.0 8,582 6 9.6
Colorectal (C18-20) 124 7 11.5 13,719 2 15.5
Oesophagus (C15) 109 8 8.3 4,196 13 4.7
Prostate (C61) 83 9 23.2 11,099 3 28.5
Stomach (C16) 77 10 6.7 3,790 14 4.3

Notes

  1. Breast cancer age-standardised rates are expressed per 100,000 females.
  2. Prostate cancer age-standardised rates are expressed per 100,000 males.

Figure 2: Age-specific mortality rates for cancer, New South Wales, Queensland, Western Australia, South Australia and the Northern Territory, 2010–2014

indigenous-cancers-fig2

Source: AIHW analysis of the Australian Cancer Database, (see source table 2).

Survival from cancer for Aboriginal and Torres Strait Islander people of Australia

Aboriginal and Torres Strait Islander people diagnosed with cancer between 2009 and 2013 had a 44% chance of surviving 5 years after a cancer diagnosis. Indigenous Australians had a significantly lower 5-year crude survival than non-Indigenous Australians (44% compared with 58%).

Survivorship population for cancer in Aboriginal and Torres Strait Islander people of Australia

The survivorship population is measured using prevalence data. Prevalence refers to the number of people alive who have previously been diagnosed with cancer.

The prevalence for one, three and five years given below are the number of Indigenous and Non-Indigenous Australians living with cancer at the end of 2012 who had been diagnosed in the preceding 1, 3, and 5 years respectively.

At the end of 2012, there were 1,020 Indigenous Australians (477 males and 543 females) living in the selected states who had been diagnosed with cancer that year. During the same period, there were 79,580 non-Indigenous Australians (43,889 males and 35,691 females) living in the same selected states who had been diagnosed with cancers that year.

One year age-standardised prevalence was lower among Indigenous Australians (351 per 100,000) than non-Indigenous Australians (361 per 100,000).

At the end of 2012, there were 2,382 Indigenous Australians (1,079 males and 1,303 females) living in the selected states who had been diagnosed with cancer in the previous three years (from 2010 to 2012). During the same period, there were 203,126 non-Indigenous Australians (111,495 males and 91,631 females) living in the same selected states who had been diagnosed with cancer in the previous three years (from 2010 to 2012).

Three year age-standardised prevalence was lower among Indigenous Australians (821 per 100,000) than non-Indigenous Australians (920 per 100,000).

At the end of 2012, there were 3,337 Indigenous Australians (1,485 males and 1,852 females) living in the selected states who had been diagnosed with cancer in the previous five years (from 2008 to 2012). During the same period, 303,771 non-Indigenous Australians (166,798 males and 136,973 females) were living in the same selected states who had been diagnosed with cancer in the previous five years (from 2008 to 2012).

Five year age-standardised prevalence was lower among Indigenous Australians (1,152 per 100,000) than non-Indigenous Australians (1,376 per 100,000).


Source tables

Source table 1: Age-specific incidence rates (per 100,000) for cancer in Indigenous and non-Indigenous Australians, New South Wales, Victoria, Queensland, Western Australia and the Northern Territory, 2008–2012
Age group (years) Indigenous Australians Non-Indigenous Australians
0–4 16.9 22.0
5–9 7.6 10.7
10–14 8.6 12.4
15–19 16.1 20.9
20–24 24.8 30.7
25–29 41.2 53.7
30–34 68.4 78.9
35–39 114.4 124.3
40–44 199.4 197.3
45–49 338.7 328.2
50–54 606.2 510.5
55–59 853.4 783.3
60–64 1,267.5 1,159.5
65–69 1,777.0 1,587.7
70–74 2,166.6 1,885.7
75+ 2,625.2 2,321.2
Source table 2: Age-specific mortality rates (per 100,000) due to cancer for Indigenous and non-Indigenous Australians, New South Wales, Queensland, Western Australia, South Australia and the Northern Territory, 2010–2014
Age group (years) Indigenous Australians Non-Indigenous Australians
0–4 2.2 2.3
5–9 1.4 2.5
10–14 0.3 1.6
15–19 2.1 3.0
20–24 5.7 3.6
25–29 7.4 6.2
30–34 8.5 9.2
35–39 30.6 18.2
40–44 56.3 31.9
45–49 110.5 63.0
50–54 213.4 112.4
55–59 367.5 194.6
60–64 510.3 318.2
65–69 798.0 494.3
70–74 1,049.3 747.4
75+ 1,522.5 1,532.5

Data notes

International Statistical Classification of Diseases and Related Health Problems Version 10 (ICD-10)

Cancer is classified by the International Statistical Classification of Diseases and Related Health Problems Version 10 (ICD-10). This is a statistical classification, published by the World Health Organization, in which each morbid condition is assigned a unique code according to established criteria.

Incidence

Cancer incidence indicates the number of new cancers diagnosed during a specified time period.

The 2008–2012 national incidence counts are considered of sufficient completeness for reporting New South Wales, Victoria, Queensland, Western Australia and the Northern Territory.

Mortality

Cancer mortality refers to the number of deaths occurring during a specified time period for which the underlying cause of death is cancer.

The 2010–2014 national mortality counts are considered of sufficient completeness for reporting New South Wales, Queensland, Western Australia, South Australia and the Northern Territory.

Survival

Data provided are for cancer-related crude survival estimates for Aboriginal and Torres Strait Islander people for the period 2009–2013. Crude survival is the proportion of people alive at a specified point in time subsequent to the diagnosis of cancer.

Crude survival estimates were calculated using the period method, instead of the cohort method, as it provides more up-to-date estimates of survival and is widely used among cancer registries.

Note that survival rates have not been age-standardised to the Australian population so any differences between the age structures of the two populations could affect comparisons.

Prevalence

Prevalence of cancer refers to the number of people alive with a prior diagnosis of cancer at a given time. It is distinct from incidence, which is the number of new cancers diagnosed within a given period of time.

Age standardised rates

Incidence, mortality and prevalence rates expressed per 100,000 population are age-standardised to the Australian population as at 30 June 2001.

Comparisons

Comparisons have been made throughout with non-Indigenous Australians, with the analysis excluding those for whom Indigenous status was not given.


References

  1. Condon J, Armstrong B, Barnes T & Zhao Y 2005. Cancer in Indigenous Australians: a review. Cancer Causes Control 14:109-21.
  2. Threlfall TJ & Thompson JR 2009. Cancer incidence and mortality in Western Australia, 2007. Perth: Western Australian Department of Health.