Australian Institute of Health and Welfare 2014 Australia’s health 2014.
Australia’s health series no. 14. Cat. no. AUS 178. Canberra: AIHW.
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4.4 The changing cancer landscape
There have been many successes, and there are many remaining challenges, in cancer control. While
the incidence of cancer is rising, the good news is that overall average mortality at the population
level is falling and real improvements in survival are continuing.
These changes in the cancer landscape are not universal, and differ greatly by cancer type and
population group. The overall average is not necessarily indicative or representative of individual
experience, where a diagnosis of cancer is anything but ‘good news’.
The observed rise in overall cancer incidence can be broadly attributed to advancements in early
detection (through organised screening programs and better detection technology), the ageing
population and changes in risk factor exposure. The observed fall in the overall cancer mortality rate
can be mainly attributed to a combination of earlier detection (at a more treatable stage) and more
effective treatments. The number of cancer-related deaths is attributable to changes in risk factor
exposure and the ageing of the population.
The net result of increasing cancer incidence and decreasing overall mortality is more people living
with cancer, that is, higher and gradually increasing prevalence due to increased survival in the
population. Better survival rates for some cancers bring an increasing emphasis on living with, and
after, a cancer diagnosis.
This article examines broadly some features of this changing landscape through:
• describing cancer and the current disease burden
• summarising the historical gains in cancer control
• estimating the future cancer disease burden and discussing emerging issues
• outlining areas where future gains could be made.
What do we know about cancer?
Box 4.1
Defining cancer
Cancer, also called malignancy, i