Aims
This presentation aims to highlight areas where efforts across disciplines could be coordinated to reduce the 1.45 million cancer deaths predicted in Australia and a widening of multifactorial gaps in outcomes between 2020 and 2044.
Methods
Data draw from comprehensive projections of Australian cancer incidence and mortality, contextualised with analyses of key drivers of predicted patterns. The projections, in the Lancet Public Health, draw from an age-period-cohort model or generalised linear model for 24 cancer types and all cancers combined. Effect of factors such as smoking prevalence and PSA testing (associated with increased prostate cancer incidence) were incorporated, as well as modelled COVID-19 impacts. It is complemented with a summary analysis of additional factors associated with predicted patterns, with a focus on inequity including underinvestment and ad hoc prioritisation of research.
Results
From 2020 to 2044, age-standardised mortality rates will fall by 21.5% in men and 20.6% in women on current trends. However, death rates will increase for cancers of the liver and uterus, while there are wide variations in improvements across cancer types (from a 36% fall in melanoma mortality rates to a 3.5% decline for pancreatic cancer). While tobacco control and sun protection will drive prevention benefits, stage-shift through ad hoc early detection and organised screening, and optimal care at all stages, will drive reduced mortality post-diagnosis. Widening variations by cancer type and between demographics will occur, unless there is systematic change. Research investment is not prioritised to need.
Conclusions
A coordinated approach to cancer research, policy and practice reform, mapped against trends in disease burden by cancer type, intervention and evidence gaps, could help drive major reductions in predicted cancer mortality and widening inequity. Cancer control professionals, informed with both clinical evidence and compelling data on trends, can be effective advocates for reform.