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Unprecedented insight into the future of cancer in Australia and what we can do to improve outcomes

In June 2022, the most comprehensive cancer incidence and mortality projections ever produced in Australia were published in The Lancet Public Health.

The study, led by Daffodil Centre researchers Dr Qingwei Luo, Associate Professor Julia Steinberg, and Professor Karen Canfell, shows that from 2020 to 2044, around 4.56 million new cancer cases will be diagnosed in Australia and cancer will cause 1.45 million deaths.

Dr Qingwei Luo

This study includes a breakdown of long-term projections in incidence and mortality for all cancers combined and across 21 cancer types, based on historical trends and incorporating key cancer-specific factors. It follows a previous retrospective study, also led by Dr Luo and published in 2020, tracking progress in incidence and mortality outcomes between 1996 and 2015.

The landmark 2020-2044 projections show where some of the major improvements in cancer control outcomes will be achieved and where the biggest challenges remain in reducing the burden of cancer.

There are variations in the incidence and mortality projections. There is, for example, a much larger projected fall in mortality rates (down by 21.5% in males and by 20.6% in females) than in incidence rates (down by 9.1% in males and by 1.1% in females). This is good news, as it reflects improved survival and an increase in earlier-stage diagnoses. The data also reflects changes in health policy and practice, such as the decreased incidence rate for males, associated in part with reduced rates of prostate-specific antigen testing and a flow-on effect in lower prostate cancer incidence rates.

These findings also show where continuing our existing research and advocacy efforts will deliver major improvements in cancer control. Among the greatest improvements will be reduced mortality from lung cancer and melanoma in men in early middle age – most of it from primary prevention, through tobacco control (lung) and sun protection (melanoma) driven by Cancer Council advocacy and independent research.

Despite these gains, lung cancer remains the leading cause of cancer deaths by an increasing margin. The widening gap in cancer deaths between lung and bowel cancer (the second-leading cause of cancer death) is largely because bowel cancer is benefiting from population screening – an area where Daffodil Centre researchers have published key independent research for informing the design of the national screening program. Lung cancer screening, in contrast, is not currently available in Australia, but it is in development.

And, while we welcome the improved melanoma outcomes, the study also estimates there will be more than 480,000 new cases between 2020 and 2044.  Making melanoma the third most commonly diagnosed cancer after prostate and breast cancer – a huge burden on the health system and the population.

Much more needs to be done to improve outcomes for all cancer types.

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