3 things to know about the future of cancer in Australia

New research by The Daffodil Centre at Cancer Council NSW and the University of Sydney, suggests that significant action is needed to save more lives from cancer in Australia over the next 25 years (2020-2044).

The study projects that the overall rate at which people die of cancer will continue to decline. However, the projected drop is smaller than the drop in the previous 25-year period, and the total number of people who will be diagnosed with or die of cancer will increase.

In other words, cancer will continue to be a significant public health challenge in the next two and a half decades. As a country, if we are to improve on these projections, we will need to invest heavily in cancer prevention and early detection, patient care and treatment.

Here are 3 things to know about the research and what it means for cancer control policy.

1. Death rates set to fall for several (but not all) cancer types

The study, published in the Lancet Public Health, predicts that the overall rate of people dying of cancer will fall by around 20%.

Two common cancers for which death rates are predicted to fall most sharply are lung cancer (43% for males and 31% for females) and melanoma (49% for males and 28% for females). These falls will be driven largely by established prevention approaches – tobacco control and sun protection respectively, as well as improved early detection and treatments for these cancers.

Australia’s cancer screening programs for bowel, breast and cervical cancers are also expected to continue to reduce the overall rate that people die of cancer in Australia. In fact, cervical cancer is set to be eliminated in Australia by as early as 2028.

From 2020 to 2044:

2. The total number of people dying of cancer in Australia is set to increase

The Daffodil Centre study projects that 4.56 million people will be diagnosed with cancer in total, and 1.45 million people will die over the next 25 years. This means that, compared to the previous 25 years, there will be 47% more people diagnosed with cancer and 36% more people dying of cancer.

Australia’s ageing and growing population are the main drivers behind these increases.

Another contributing factor is that the rates (as distinct from the numbers) of some cancers are set to become more common in Australia, including kidney, liver and pancreatic cancers. And, although the death rate for kidney and pancreatic cancers is set to decline slightly, it is projected to increase for liver cancer by as much as 21%.

3. Greater investment in cancer prevention and screening is needed

While these figures may seem overwhelming, we know from other research findings that tens of thousands of additional lives could be saved through established interventions and many more through prioritised research investment. However, to achieve this, significant investment – particularly from governments – will be required.

One example is the National Bowel Cancer Screening Program. Currently, around 40 per cent of people are eligible for the program participate in it – which is expected to prevent 92,200 new bowel cancer cases and 59,000 deaths between now and 2040. However, a further 37,300 cases and 24,800 deaths could be avoided if participation increased to 60 per cent.

Lung cancer is another example. While significant progress has been made to reduce its impact, it is still expected to remain the leading cause of cancer death over the next two decades (by a wide margin) – with 80% of these deaths caused by smoking.

Research has consistently shown that the most effective way to discourage smoking is through a range of population-level interventions, including hard-hitting mass media antismoking campaigns in tandem with price control and measures to make smoking less attractive and eliminating the influence of the tobacco industry.

On 30 November 2022, consistent with federal Cancer Council advocacy, the Australian Minister for Health, Mark Butler, announced a plan to introduce a range of reforms to this end. The priority now is for governments to invest in hard-hitting antismoking campaigns like Australia’s highly effective National Tobacco Campaign and ads run by the Cancer Institute NSW. It’s now been more than a decade since the last national mass media antismoking campaign was run in Australia and state-based investment has also dramatically fallen.

A separate promising development in lung cancer control is the growing support for lung cancer screening, as finding lung cancer early is key to survival if it can’t be prevented. Daffodil Centre research strengthens the economic case for lung cancer screening, which has already been trialled successfully in clinical studies. In October 2022, the independent Medical Services Advisory Committee (MSAC) recommended the Australian Government introduce such a program, drawing on Daffodil Centre research as part of its determination.

The Daffodil Centre’s research predicts that overall cancer rates are likely to fall over the next 25 years. But this fall is smaller than in the previous two decades. And the total number of people who will be diagnosed or die of cancer will increase.

It is clear that cancer will remain a significant public health challenge in the coming decades. To curb its impact, we are calling on governments to invest more heavily in cancer prevention and screening programs – initiatives that we know save lives.