Cancer

Cancer is a large range of diseases in which some of the body’s cells become defective, begin to multiply out of control, can invade and damage the area around them, and can also spread to other parts of the body to cause further damage.

As of December 2018, there were more than 1.2 million people alive in Australia who had previously been diagnosed with cancer. During 2015–2019, 7 in 10 people (71%) survived for at least 5 years after their cancer diagnosis; an increase from 5 in 10 (53%) 25 years earlier during 1990–1994.

How common is cancer?

In 2023, it is estimated that:

• About 165,000 new cases of cancer were diagnosed in Australia, an average of over 450 every day; more than half (55%) of these cases were diagnosed in males.
• The most commonly diagnosed cancers in males were prostate cancer (25,500 cases), melanoma of the skin (10,600 cases), colorectal cancer (8,100 cases) and lung cancer (7,700 cases).
• The most commonly diagnosed cancers in females were breast cancer (20,500 cases), melanoma of the skin (7,600 cases), colorectal cancer (7,200 cases), and lung cancer (7,100 cases).

The age-standardised incidence rate (see glossary) for all cancers combined rose from 383 cases per 100,000 people in 1982 to a peak of 507 cases per 100,000 in 2008, then to 496 cases per 100,000 in 2019. Age-standardised rates are estimated to have remained similar at 503 cases per 100,000 people in 2023 (Figure 1). 

Consistent with Australia’s growing and ageing population, between 2000 and 2023, the number of:

• new cancer cases increased by 88%
• deaths from cancer increased by 41%.

However, adjusted for age, the rate at which new cancer cases were diagnosed increased by only 8% while the rate at which people died due to cancer decreased by 25%, (and by 32% over the last 30 years; Figure 2). This decrease in mortality rate reflects reductions in death rates for common cancers such as lung (33% decline between 2000 and 2023), colorectal (43% decline), prostate (31% decline), and female breast cancer (27% decline), amongst others. 

For more information, see Cancer data in Australia.

Figure 1: Cancer cases and age-standardised incidence rates, by sex, 1982 to 2023

The increasing trend to 2008 was largely due to a rise in the number of diagnosed prostate cancers in males and breast cancer in females. This trend may have been the result of increased prostate-specific antigen testing, the introduction of national cancer screening programs, and improvements in technologies and techniques used to identify and diagnose cancer.

Australia’s ageing population and cancer

The Australian population is ageing, and the risk of being diagnosed with cancer increases with age. With more Australians living to older ages, as well as rapid population growth, the number of cancer cases diagnosed each year continues to rise. The Australian population is expected to increase by 12% (about 3.3 million people) between 2024 and 2033 (ABS 2022), while cancer cases are estimated to increase by around 22% (reflecting growth in the population of older people as well as general population increase).

It is estimated that around 204,000 cases of cancer will be diagnosed in 2033, and that between 2024 and 2033, a total of around 1.9 million cases of cancer will be diagnosed. For more information, see Cancer data in Australia.

Socioeconomic area

Socioeconomic disadvantage tends to be associated with poorer health and poorer health outcomes.

In the period 2012–2016, the age-standardised incidence rate for all cancers combined was 5% higher in the most disadvantaged areas (509 cases per 100,000) compared with the least disadvantaged areas (484 cases per 100,000).

For 3 of the 4 most commonly diagnosed cancers (prostate, breast cancer and melanoma of the skin – just under 40% of all cancers diagnosed), age-standardised incidence rates were lower (0.8 to 0.85 times as high) in the most disadvantaged areas compared with the least disadvantaged areas.

For almost all of the other most commonly diagnosed cancers, rates were higher in the more disadvantaged areas than in the less disadvantaged areas, being:

• between 1.1 and 1.2 times higher for colorectal cancer, pancreatic cancer, bladder cancer, uterine cancer;
• about 1.3 times higher for kidney cancer;
• between 1.5 and 1.6 times higher for head and neck cancers, cancer of unknown primary site, liver cancer and cervical cancer; and
• 1.8 times higher for lung cancer.

Survival was lower and mortality higher for people in the most disadvantaged areas compared with those in the least disadvantaged areas, with 5-year observed survival rates around 12 percentage points lower (56% compared with 68% in 2012–2016), and cancer mortality rates over 40% higher (185 deaths per 100,000 compared with 130 deaths per 100,000 in 2015–2019).

For more information, see Cancer in Australia 2021.

Aboriginal and Torres Strait Islander (First Nations) people

In the period 2014–2018, an average of around 1,900 cases of cancer were diagnosed among First Nations people per year (in New South Wales, Victoria, Queensland, Western Australia and Northern Territory). The age-standardised incidence rate for all cancers combined was 12% higher for First Nations people than for non-Indigenous Australians. 

For the 2014–2018 period:

• Prostate cancer was the most common cancer diagnosis in First Nations males (on average, 153 cases per year).
• Breast cancer was the most common cancer diagnosis in First Nations females (on average, 230 cases per year).
• Lung cancer was the most common cancer diagnosis for First Nations people overall and the second most common cancer diagnosis for each sex (on average, 147 cases per year for males and 134 cases per year for females).

Stage at diagnosis 

Cancer stage at diagnosis refers to the extent or spread of cancer at the time of diagnosis. The AIHW, Cancer Australia and state and territory cancer registries worked together to undertake a pilot to produce national population-level data on cancer stage at diagnosis for the 5 most commonly diagnosed cancers (breast, prostate, colorectal and lung cancers and melanoma of the skin) diagnosed in 2011. These cancers were assigned a ‘stage’ from I to IV. The higher the number, the further the cancer had spread at the time of diagnosis. 

The 2011 pilot data remain the most recent national data available, however from 2024, AIHW and the state and territory cancer registries anticipate commencing a national project to boost capacity and capability to collect cancer stage and recurrence data. 

Collection and analysis of data on cancer stage at diagnosis enhances the understanding of the variation in cancer stage at the time of diagnosis and how it affects survival. Earlier stage at diagnosis is linked with better survival rates (see Survival by stage of diagnosis below).

In 2011:

• Most cancers were diagnosed at stage I or II (66%), with melanoma of the skin having the highest percentage diagnosed at stage I (78%).
• 12% of cases diagnosed with one of the 5 most commonly diagnosed cancers presented with a stage IV cancer.
• Stage IV cancer accounted for 42% of lung cancers diagnosed, which was the highest percentage of the 5 cancers.

Participation in national screening programs for breast, colorectal and cervical cancer has been associated with substantially better outcomes (higher probability of survival, lower death rates – see Cancer in Australia 2021). Similar benefits are expected from the soon to be introduced national lung cancer screening program.

More recent data on stage at diagnosis or extent of disease at diagnosis has been published for at least two jurisdictions (VCR 2023; Cancer Institute NSW 2022), showing broadly similar stage profiles compared with 2011.

Cancer treatment

While population-based cancer screening in Australia focuses on asymptomatic populations for breast, cervical and bowel cancers, treatments for cancer aim to improve outcomes for individuals once they have received a cancer diagnosis, irrespective of the cancer type. Summaries of some key areas of cancer treatment (hospitalisations, chemotherapy, radiotherapy and palliative care) are presented below.

For information about cancer screening programs, see Cancer screening.

Cancer-related hospitalisations

In the 2021–22 financial year, there were around 1.4 million cancer-related hospitalisations, accounting for about 1 in 8 of all hospitalisations in Australia. Reflecting the increase in the number of cancer diagnoses over time, the number of cancer-related hospitalisations has increased steadily over this period from 0.9 million in 2010–11, when these accounted for 1 in 10 of all hospitalisations in Australia (see Cancer in Australia 2012). 

Of cancer-related hospital admissions in 2021–22:

• 75% were same-day hospitalisations (see glossary). The large number of same-day hospitalisations is in part accounted for by the number of chemotherapy treatments
• 25% were overnight hospitalisations (see glossary), with an average length of stay of 7.6 days. Acute myeloid leukaemia had the longest average length of stay (15.5 days), followed by hypopharyngeal cancer (12.7 days) and cancer of other central nervous system (12.3 days)
• non-melanoma skin cancer was the most common cancer recorded as a principal diagnosis (24%), followed by prostate cancer (10%) and cancer of secondary site (8.3%).

When compared with 2010–11, the proportion of hospitalisations that are overnight, the overall average length of stay and the most common cancers for which hospitalisation occurred in 2021–22, have not changed appreciably (see Cancer in Australia 2012).

Chemotherapy and radiotherapy

Chemotherapy involves the use of drugs (chemicals) to prevent or treat disease (in this case, cancer). Radiotherapy is the use of X-rays to destroy or injure cancer cells so they cannot multiply and is an important part of cancer treatment (Barton et al. 2014).

Chemotherapy and radiotherapy can be used on their own or in combination with other treatment methods.

In 2023, 625,000 chemotherapy and 2.7 million radiotherapy services were provided through the Medicare Benefits Schedule (MBS).

For information on chemotherapy and radiotherapy treatments that were not subsidised through the MBS, see Cancer in Australia 2021.

Palliative care

Palliative care – which can include ‘hospice care’, ‘end-of-life care’ and ‘specialist palliative care’, and can include care provided during any stage of a patient’s journey (including during curative treatments) – is an approach that aims to improve the quality of life of patients and their families facing the problems associated with life-limiting illness. This is done through the prevention and relief of suffering by means of early identification and assessment and treatment of pain and other problems, physical, psychosocial and spiritual (WHO 2002).

In 2021–22, around 53,300 cancer-related hospitalisations in Australia (of which 37,900 had a principal diagnosis of cancer) involved palliative care – these accounted for 56% of all palliative care hospitalisations.

The most common type of cancer recorded for palliative care hospitalisation where cancer was the principal diagnosis, was secondary site cancer (22%), followed by lung cancer (14%), colorectal (bowel) cancer (7.9%) and pancreatic cancer (7.1%). Of the cancer-related hospitalisations involving palliative care, 48% ended in death, while 52% ended in transfer to another facility or discharge to home. 

For more information on cancer-related treatments, see Cancer in Australia 2021.

Cancer survival

Information on survival from cancer indicates cancer prognosis and the effectiveness of treatment available. ‘Relative survival’ refers to the probability of being alive for a given amount of time after diagnosis compared to the general population (see glossary). A 5-year relative survival figure of 100% means that the cancer has no impact on people’s chance of still being alive 5 years after diagnosis, compared with the general population, whereas a figure of 50% means that the cancer has halved that chance.

During 2015–2019 in Australia:

• Individuals diagnosed with cancer had, on average, a lower (71%) chance of surviving for at least 5 years after diagnosis compared with their counterparts in the general population (referred to as ‘5-year relative survival’).
• Females had a slightly higher 5-year relative survival rate (72%) than males (69%).
• Survival rates vary considerably between cancer types – cancers such as testicular and thyroid cancers have 5-year relative survival rates over 95% while cancers such as pancreatic cancer and mesothelioma have 5-year relative survival rates of less than 20%.
• 5-year relative survival rates for the two most common cancers were 92% for females diagnosed with breast cancer and 96% for males diagnosed with prostate cancer.
• 5-year survival rates increased from 5 in 10 (53%) in 1990–1994 to 7 in 10 (71%) in 2015–2019.

For more information, see Cancer data in Australia.

Survival by stage of diagnosis

The stage of cancer at diagnosis and subsequent treatment outcomes are important determinants of cancer survival. Five-year relative survival rates were highest for cancers diagnosed at earlier stages. 

For the 5 cancers where stage at diagnosis data was collected in 2011, 5-year relative survival for:

• Breast cancer in females at Stage I was 100%; at Stage IV it was 32%.
• Colorectal cancer at Stage I was 99%; at Stage IV it was 13%.
• Lung cancer at Stage I was 68%; at Stage IV it was 3.2%.
• Melanoma of the skin at Stage I was 99%; at Stage IV it was 26%.
• Prostate cancer in males at Stage I was 100%; at Stage IV it was 36%.

More recent data on survival by stage has been published for at least one jurisdiction (VCR 2023), and shows a broadly similar survival gradient across stage.

What are the impacts of cancer?

Deaths

Even though cancer survival rates have increased and cancer mortality rates continue to decrease, cancer accounts for around 3 out of every 10 deaths in Australia. It is estimated that in 2023, around 51,300 people will have died from cancer, an average of around 140 deaths every day. Males are estimated to account for 56% of these deaths. 

The age-standardised cancer mortality rate has decreased from 209 deaths per 100,000 people in 1982 to an estimated 145 deaths per 100,000 people in 2023 (Figure 2). For more information, see Cancer data in Australia.

Figure 2: Cancer-related deaths and age-standardised mortality rates, by sex, 1982 to 2023

Burden of disease

Burden of disease analysis measures the impact of disease and injury in a population by estimating the ‘disability-adjusted life years’ (DALY) experienced by the population. This measure counts the combined years of healthy life lost due to living with disease and injury (non-fatal burden), and dying prematurely (fatal burden).

In 2022, cancer contributed to 17% of the total disease burden, which was more than any other disease group. Dying from cancer accounted for 32% of the fatal burden in Australia. 

A large proportion (42%) of the cancer burden is attributable to personal and behavioural risk factors (for example, smoking (22%) and overweight and obesity (7%)).

For more information, see Burden of Disease.

Expenditure

In 2020–21, total recurrent expenditure on health goods and services was $210 billion, of which, $150 billion (71.6%) was able to be attributed to specific disease groups. Cancer and other neoplasms (tumours) was the disease group with the second greatest health system expenditure ($14.6 billion), accounting for 9.7% of the $150 billion disease-specific expenditure.

For more information, see Health system spending on disease and injury in Australia, 2020-21.

Where do I go for more information?

For more information on cancer, see:

• Australian Burden of Disease Study 2022
• Cancer data in Australia
• Cancer in Australia 2021
• Health system spending on disease and injury in Australia, 2020-21

For more on this topic, see Cancer.