Cancer in Victoria: statistics & trends 2012

This report is a compilation of the latest available Victorian cancer statistics.Key messages:IncidenceCancer is a leading cause of disease burden in Victoria with an average of 80 new diagnoses every day. In 2012, 29,387 Victorians were diagnosed with cancer.Cancer incidence rates continue to increase (annual increases of 0.8% for men and 0.6% for women).MortalityThere are 30 deaths from cancer in Victoria every day. In 2012, 10,780 people died from cancer.Death rates have declined steadily since 1982 (falls of 1.4% per year for males and 1.1% for females). This reflects earlier detection of cancers through screening, falling tobacco use, especially by males, and improvements in treatment.In 2012, cancer deaths in Victoria resulted in the premature loss of nearly 60,000 years of life. This is more than four times the loss resulting from other major causes of death.Most common cancersBreast cancer is the most common new cancer for Victorian women with almost 3,700 diagnoses in 2012 (28% of all cancers).Though prostate cancer incidence rates declined from 2009 to 2012, it remains the most common new cancer for Victorian men with almost 4,800 new diagnoses in 2012 (30% of all cancers).The five most common cancers in Victoria are prostate, bowel, breast, lung and melanoma. These account for almost 60% of all new cancers and half of cancer deaths.Less common cancersIn this report, we highlight some less common cancers for which incidence rates are increasing, including liver and thyroid cancer.Liver cancer - incidence rates are increasing by more than 4% per year in both men and women which is largely due to prevalence of chronic hepatitis B infection. However, vaccination is now recommended to persons at increased risk of hepatitis B infection, including migrants from countries where this is common, those in contact with infected individuals, recipients of blood products and children.Thyroid cancer - is three times more common in women than in men and is increasing by over 6% and 5% per year respectively. The differences between the sexes may include increased incidence and treatment of non-cancerous thyroid disease in females resulting in incidental detection of asymptomatic cancers.Aboriginal and/or Torres Strait Islander VictoriansThere are over 90 new diagnoses of cancer and almost 40 deaths for Aboriginal and/or Torres Strait Islander Victorians each year.Overall cancer incidence rates were higher for Aboriginal and/or Torres Strait Islander Victorian women than for Victorian women of other descent but male rates did not differ significantly.Mortality rates were significantly higher for Aboriginal and/or Torres Strait Islander Victorians than Victorians of other descent for both men and women.Trends in cervix cancerThe incidence rate of cervix cancer in Victorian women has fallen by 45% in the last twenty years, with death rates falling by 61% over the same period. This decline is largely attributable to the success of the population-based organised screening program.Staging data for 2008-2009 show that almost 60% of women are diagnosed with early disease. In women aged less than 30 years, almost 90% have stage 1 cancer. Stage 4 disease is most prominent (15%) in women aged over 50 years.SurvivalDuring the period 1987-2011, five-year survival increased from 47% to 66%.ProjectionsIt is estimated that by 2023-2027 the annual incidence of cancer will reach over 44,000, an increase of 53% from 2008-2012.During the same period, deaths from cancer will increase to over 13,000 per year. Though actual numbers of new cases and deaths are increasing rapidly, this is largely due to the growth and ageing of the Victorian population. Edited by Vicky Thursfield, Carolyn Staines, Graham Giles, and Helen Farrugia

Assessing the feasibility and validity of the Toronto Childhood Cancer Stage Guidelines:a population-based registry study

Background: Cancer stage at diagnosis is crucial for assessing global efforts to increase awareness of childhood cancer and improve outcomes. However, consistent information on childhood cancer stage is absent from population cancer registries worldwide. The Toronto Childhood Cancer Stage Guidelines, compiled through an international consensus process, were designed to provide a standard framework for collection of information on stage at diagnosis of childhood cancers. We aimed to assess the feasibility of implementing the Toronto Guidelines within a national population cancer registry. Methods: We did a population-based registry study using data from the Australian Childhood Cancer Registry and included data from children aged 0–14 years diagnosed between Jan 1, 2006, and Dec 31, 2010 with one of 16 childhood cancers listed in the Toronto Guidelines (acute lymphoblastic leukaemia, acute myeloid leukaemia, Hodgkin's lymphoma, non-Hodgkin lymphoma, neuroblastoma, Wilms' tumour, rhabdomyosarcoma, non-rhabdomyosarcoma soft tissue sarcoma, osteosarcoma, Ewing's sarcoma, retinoblastoma, hepatoblastoma, testicular cancer, ovarian cancer, medulloblastoma, and ependymoma). We extracted data from medical records, and assigned stage according to the Tier 1 criteria (basic) and Tier 2 criteria (more detailed, requiring data from cytology, imaging, and other diagnostic tests, where available) using computer algorithms derived from the Toronto Guidelines. Additionally, expert reviewers independently assigned Tier 2 stage to a random subsample of 160 cases (ten per malignancy type). Feasibility of the guidelines was assessed on the percentage of cases that could be staged, agreement between stage assigned by the algorithms and the expert reviewers, and the mean time (min) taken to collect the required data. Findings: We obtained data for 1412 eligible children. Stage could be assigned according to Tier 2 criteria for 1318 (93%) cases, ranging from 48 (84%) of 57 cases of non-rhabdomyosarcoma soft tissue sarcoma to 46 (100%) cases of hepatoblastoma. According to Tier 1 criteria, stage could be assigned for 1329 (94%) cases, ranging from 131 (87%) of 151 cases of acute myeloid leukaemia to 46 (100%) cases of hepatoblastoma. By contrast, stage at diagnosis was recorded by the treating physician for 555 (39%) of the 1412 cases. The computer algorithm assigned the same stage as did one or more independent expert reviewers in 155 (97%) of the 160 cases assessed. The mean time taken to review medical records and extract the required data was 18·0 min (SD 9·5 per case). Interpretation: The Toronto Guidelines provide a highly functional framework that can be used to assign cancer stage at diagnosis using data routinely available in medical records for most childhood cancers. Data on staging have the potential to inform interventions targeting improved diagnosis and survival. Funding: Cancer Australia

Changes in colorectal cancer incidence in seven high-income countries: a population-based study

Background: The overall incidence of colorectal cancer is decreasing in many high-income countries, yet analyses in the USA and other high-income countries such as Australia, Canada, and Norway have suggested increasing incidences among adults younger than 50 years. We aimed to examine longitudinal and generational changes in the incidence of colon and rectal cancer in seven high-income countries. Methods: We obtained data for the incidence of colon and rectal cancer from 20 population-based cancer registries in Australia, Canada, Denmark, Norway, New Zealand, Ireland, and the UK for the earliest available year until 2014. We used age–period–cohort modelling to assess trends in incidence by age group, period, and birth cohort. We stratified cases by tumour subsite according to the 10th edition of the International Classification of Diseases. Age-standardised incidences were calculated on the basis of the world standard population. Findings: An overall decline or stabilisation in the incidence of colon and rectal cancer was noted in all studied countries. In the most recent 10-year period for which data were available, however, significant increases were noted in the incidence of colon cancer in people younger than 50 years in Denmark (by 3·1%; per year), New Zealand (2·9% per year), Australia (2·9% per year), and the UK (1·8% per year). Significant increases in the average annual percentage change in the incidence of rectal cancer were also noted in this age group in Canada (by 3·4% per year), Australia (2·6% per year), and the UK (1·4% per year). Contemporaneously, in people aged 50–74 years, the average annual percentage change in the incidence of colon cancer decreased significantly in Australia (by 1·6% per year), Canada (1·9% per year), and New Zealand (3·4% per year) and of rectal cancer in Australia (2·4% per year), Canada (1·2% per year), and the UK (1·2% per year). Increases in the incidence of colorectal cancer in people younger than 50 years were mainly driven by increases in distal (left) tumours of the colon. In all countries, we noted non-linear cohort effects, which were more pronounced for rectal than for colon cancer. Interpretation: We noted a substantial increase in the incidence of colorectal cancer in people younger than 50 years in some of the countries in this study. Future studies are needed to establish the root causes of this rising incidence to enable the development of potential preventive and early-detection strategies