Every day in Australia, around five Aboriginal and Torres Strait Islander people are diagnosed with cancer. 1,2
Cancer incidence refers to the number of new cases of cancer diagnosed in a specified time period.
Cancer incidence data for Aboriginal and Torres Strait Islander peoples are available from four states and territories: New South Wales, Queensland, Western Australia and the Northern Territory.1,2
In these four jurisdictions, during 2011–2015, 3435 Aboriginal and Torres Strait Islander men and 3490 Aboriginal and Torres Strait Islander women were diagnosed with cancer. This equated with about 500 out of every 100,000 Aboriginal and Torres Strait Islander people in these states and territories being diagnosed with cancer each year.1,2
The most common cancers diagnosed among Aboriginal and Torres Strait Islander people are lung cancer, female breast cancer, colorectal cancer, prostate cancer and head and neck cancer. Some cancers are more common among Aboriginal and Torres Strait Islander people compared with the rest of the Australian population. They include lung cancer, liver cancer, head and neck cancer and cervical cancer.1
As with the general population, the likelihood of an Aboriginal or Torres Strait Islander person being diagnosed with a cancer increases with increasing age.1 The age-standardised incidence rate for most cancer types is higher among Aboriginal and Torres Strait Islander men than women.1
About this measure
This measure provides data on cancer incidence for Aboriginal and Torres Strait Islander peoples sourced from New South Wales, Queensland, Western Australia and the Northern Territory. The data account for about 82.9%4 of all Aboriginal and Torres Strait Islander people in Australia.
Data source
When a new case of cancer in Australia is diagnosed, it is reported to the cancer registry in the state or territory where the person lives. Notification of new cancer diagnoses to the cancer registry is required by law. National data, using data from each state and territory cancer registry, is collated in the Australian Cancer Database, which is maintained by the Australian Institute of Health and Welfare (AIHW).5
Data about cancer among Aboriginal and Torres Strait Islander peoples in Australia rely on information being collected in cancer registries about whether a person diagnosed with cancer identifies as Aboriginal or Torres Strait Islander. While every registry collects information about Aboriginal and Torres Strait Islander status, the consistency of this information varies. For more information see ‘Aboriginal and Torres Strait Islander identification in national cancer data’. Currently, information about Aboriginal and Torres Strait Islander status from cancer registries in four states and territories is considered to have sufficient consistency for inclusion in national reports and analyses of cancer incidence: i.e., New South Wales, Queensland, Western Australia, and the Northern Territory.
Cases vs rates
Cancer incidence data are presented as absolute numbers of cases or as incidence rates. Absolute numbers indicate the total number of cases of cancer diagnosed in a specified time period. Cancer incidence rates are reported as the number of cases of cancer diagnosed per 100,000 people in the population of interest. Incidence rates are often age-standardised to remove the influence of age when comparing cancer data among different populations. This is because the likelihood of being diagnosed with most types of cancer increases with age.1,3 Cancer incidence rates in Australia are standardised to the Australian population as at 30 June 2001.
For example:5
• number of cases: in 2011–2015, 1,040 Aboriginal and Torres Strait Islander people were diagnosed with lung cancer
• age-standardised incidence: in 2011–2015, the age-standardised incidence rate of lung cancer among Aboriginal and Torres Strait Islander people was 82.8 cases per 100,000 people.
Age-specific cancer incidence rates are used to compare cancer incidence across specific age groups.1,3
For example:5
• during the period 2011–2015, the incidence of lung cancer among Aboriginal and Torres Strait Islander people aged 55–64 years was 195.1 cases per 100,000 people compared with 341.2 cases per 100,000 people for those aged 85+ years.
Cancer types
Data about cancer incidence (including age-standardised and age-specific incidence data) are published by the AIHW for individual cancer types and cancer groupings.3 Tumour types and groupings are classified by ICD-10 code.6 Cancer incidence data exclude basal and squamous cell carcinomas of the skin.5
Current status
Data appear to be of equivalent consistency for New South Wales, Queensland, Western Australia and the Northern Territory, with these four jurisdictions accounting for 82.9% of Aboriginal and Torres Strait Islander people.4 The data provided here on cancer incidence rates for Aboriginal and Torres Strait Islander peoples are sourced from these four jurisdictions.
All cancers combined (ICD-10 codes C00–C96, D45, D46, D47.1, D47.3–D47.5, except basal and squamous cell carcinomas of the skin which are part of C44)
In the period 2011−2015, there were 6,925 new cases of cancer diagnosed among Aboriginal and Torres Strait Islander people (3,435 in males and 3,490 in females).5 In the same period, the age-standardised incidence rate was 496.3 cases per 100,000 persons (566.4 for males and 446.7 for females). Cancer incidence rates increased with age; this increase was more pronounced in males than females; with this difference between genders being most apparent in age groups of 55–64 years and older.5
Choose a cancer type below for further information:
In the period 2011−2015, there were 103 new cases of bladder cancer diagnosed among Aboriginal and Torres Strait Islander people (77 in males and 26 in females).5
In the same period, the age-standardised incidence rate was 10.2 cases per 100,000 persons (17.8 cases per 100,000 males and 4.7 cases per 100,000 females). Bladder cancer incidence rates increased with age.5
In the period 2011−2015, there were 96 new cases of brain cancer diagnosed among Aboriginal and Torres Strait Islander people (52 in males and 44 in females).5
In the same period, the age-standardised incidence rate was 4.6 cases per 100,000 persons (4.4 cases per 100,000 males and 4.6 cases per 100,000 females). Brain cancer incidence rates varied across age groups, with the highest rate for the 75-84-year range for males and females combined. 5
In the period 2011−2015, there were 810 new cases of breast cancer diagnosed among Aboriginal and Torres Strait Islander females.5
In the same period, the age-standardised incidence rate was 97.0 cases per 100,000 females. Breast cancer incidence rates generally increased with age.5
In the period 2011−2015, there were 146 new cases of cervical cancer diagnosed among Aboriginal and Torres Strait Islander females.5
In the same period, the age-standardised incidence rate was 14.0 cases per 100,000 females. Cervical cancer incidence rates varied across age groups, between 10.9 and 42.2 cases per 100,000 females between in the ages of 25-34 years and the age range of 75-84 years which exceeds the principal screening target of 50 to 74 years of age.5
In the period 2011−2015, there were 613 new cases of colorectal cancer diagnosed among Aboriginal and Torres Strait Islander people (319 in males and 294 in females).5
In the same period, the age-standardised incidence rate was 48.1 cases per 100,000 persons (53.6 cases per 100,000 males and 43.3 cases per 100,000 females). Colorectal cancer incidence rates increased with age.5
In the period 2011−2015, there were 469 new cases of head and neck cancer diagnosed among Aboriginal and Torres Strait Islander people (348 in males and 121 in females).5
In the same period, the age-standardised incidence rate was 28.0 cases per 100,000 persons (43.5 cases per 100,000 males and 14.4 cases per 100,000 females). Head and neck cancer incidence rates were higher in males than females across all age groups and generally increased with age.5
In the period 2011−2015, 234 new cases of liver cancer were diagnosed among Aboriginal and Torres Strait Islander people (170 in males and 64 in females).5
In the same period, the age-standardised incidence rate was 15.4 cases per 100,000 persons (24.2 cases per 100,000 males and 8.1 cases per 100,000 females). Liver cancer incidence rates were higher in males than females and generally increased with age.5
In the period 2011−2015, there were 1,040 new cases of lung cancer diagnosed among Aboriginal and Torres Strait Islander people (539 in males and 501 in females). 5
In the same period, the age-standardised incidence rate was 82.8 cases per 100,000 persons (97.3 cases per 100,000 males and 72.4 cases per 100,000 females). Lung cancer incidence rates were higher in males than females and generally increased with age.5
In the period 2011−2015, there were 201 new cases of melanoma diagnosed among Aboriginal and Torres Strait Islander people (120 in males and 81 in females).5
In the same period, the age-standardised incidence rate was 15.4 cases per 100,000 persons (22.9 cases per 100,000 males and 10.1 cases per 100,000 females). Melanoma incidence rates were higher in males than females and generally increased with age.5
In the period 2011−2015, 189 new cases of Non-Hodgkin Lymphoma were diagnosed among Aboriginal and Torres Strait Islander people (106 in males and 83 in females). 5
In the same period, the age-standardised incidence rate was 13.1 cases per 100,000 persons (16.8 cases per 100,000 males and 10.1 cases per 100,000 females). Non-Hodgkin lymphoma incidence rates were generally higher for males than females and generally increased with age, particularly for males in age group of 65–74 years and older. 5
In the period 2011−2015, there were 147 new cases of oesophageal cancer diagnosed among Aboriginal and Torres Strait Islander people (108 in males and 39 in females). 5
In the same period, the age-standardised incidence rate was 10.8 cases per 100,000 persons (16.2 cases per 100,000 males and 6.1cases per 100,000 females). 5 Oesophageal cancer incidence rates were higher in males than females and generally increased with age. 5
In the period 2011−2015, there were 88 new cases of ovarian cancer diagnosed among Aboriginal and Torres Strait Islander females. 5
In the same period, the age-standardised incidence rate was 11.0 cases per 100,000 females. Ovarian cancer incidence rates increased with age. 5
In the period 2011−2015, there were 215 new cases of oesophageal cancer diagnosed among Aboriginal and Torres Strait Islander people (109 in males and 106 in females). 5
In the same period, the age-standardised incidence rate was 17.2 cases per 100,000 persons (18.4 cases per 100,000 males and 16.3 cases per 100,000 females).5 Pancreatic cancer incidence rates were similar among males and females and increased with age. 5
In the period 2011−2015, there were 575 new cases of prostate cancer diagnosed among Aboriginal and Torres Strait Islander males.5
In the same period, the age-standardised incidence rate was 111.2 cases per 100,000 males. Prostate cancer incidence rates increased with age.5
In the period 2011−2015, there were 210 new cases of cancers of unknown primary site diagnosed among Aboriginal and Torres Strait Islander people (103 in males and 107 in females). 5
In the same period, the age-standardised incidence rate was 18.0 cases per 100,000 persons (18.1 cases per 100,000 males and 17.8 cases per 100,000 females).5 Unknown primary cancer incidence rates generally increased with age for both males and females.; this effect was most pronounced for males aged 65-74 years and older and for females aged 75–84years and older.5
In the period 2011−2015, there were 238 new cases of uterine cancer diagnosed among Aboriginal and Torres Strait Islander females.5
In the same period, the age-standardised incidence rate was 28.0 cases per 100,000 females. Uterine cancer incidence rates generally increased with age; this effect was most pronounced among females in age groups of 55–64 years and older. 5
Trends
Trend estimates are available for by comparing data for the consecutive 5-year periods 2006–2010 and 2011–2015.
All cancers combined (ICD-10 codes C00–C96, D45, D46, D47.1, D47.3–D47.5, except basal and squamous cell carcinomas of the skin which are part of C44)
From 2006–2010 to 2011–2015, the age-standardised incidence rate for Aboriginal and Torres Strait Islander people remained about the same- 495 per 100,000 persons in 2006–2010 and 496 per 100,000 persons in 2011–2015.5 Among Aboriginal and Torres Strait Islander males, the age-standardised incidence decreased from 597 in 2006–2010 to 566 in 2011–2015 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate increased from 427 in 2006–2010 to 447 in 2011–2015 per 100,000 females.5
Choose a cancer type below for further information:
From 2006–2010 to 2011–2015, the age-standardised bladder cancer incidence rate for Aboriginal and Torres Strait Islander people increased slightly from 9.3 to 10.2 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate increased from 15.2 to 17.8 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate decreased slightly from 5.6 to 4.7 per 100,000 females.5
From 2006–2010 to 2011–2015, the age-standardised brain cancer incidence rate for Aboriginal and Torres Strait Islander people decreased slightly from 5.2 to 4.6 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate remained the same at 4.4 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate decreased slightly from 5.5 to 4.6 per 100,000 females. 5
From 2006–2010 to 2011–2015, the age-standardised breast cancer incidence rate for Aboriginal and Torres Strait Islander females increased from 88.7 to 97.0 new cases per 100,000 females.5
From 2006–2010 to 2011–2015, the age-standardised cervical cancer incidence rate for Aboriginal and Torres Strait Islander females decreased from 15.9 to 14.0 new cases per 100,000 females.5
From 2006–2010 to 2011–2015, the age-standardised bowel cancer incidence rate for Aboriginal and Torres Strait Islander people decreased from 52.9 to 48.1 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate decreased from 66.0 to 53.6 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate decreased slightly from 43.8 to 43.3 per 100,000 females.5
From 2006–2010 to 2011–2015, the age-standardised head and neck cancer incidence rate for Aboriginal and Torres Strait Islander people decreased slightly from 29.2 to 28.0 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate decreased from 50.0 to 43.5 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate increased from 12.8 to 14.4 per 100,000 females.5
From 2006–2010 to 2011–2015, the age-standardised liver cancer incidence rate for Aboriginal and Torres Strait Islander people decreased slightly from 16.5 to 15.4 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate increased slightly from 23.3 to 24.2 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate decreased from 11.0 to 8.1 per 100,000 females.5
From 2006–2010 to 2011–2015, the age-standardised lung cancer incidence rate for Aboriginal and Torres Strait Islander people increased from 81.1 to 82.8 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate decreased from 109.8 to 97.3 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate increased from 62.0 to 72.4 per 100,000 females. 5
From 2006–2010 to 2011–2015, the age-standardised melanoma of the skin incidence rate for Aboriginal and Torres Strait Islander people decreased slightly from 15.6 to 15.4 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate remained the same at 22.9 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate decreased slightly from 10.9 to 10.1 per 100,000 females. 5
From 2006–2010 to 2011–2015, the age-standardised non-Hodgkin lymphoma incidence rate for Aboriginal and Torres Strait Islander people decreased from 14.3 to 13.1 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate increased from 14.2 to 16.8 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate decreased from 14.0 to 10.1 per 100,000 females. 5
From 2006–2010 to 2011–2015, the age-standardised oesophageal cancer incidence rate for Aboriginal and Torres Strait Islander people increased from 9.1 to 10.8 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate increased slightly from 15.4 to 16.2 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate increased from 4.1 to 6.1 per 100,000 females.5
From 2006–2010 to 2011–2015, the age-standardised ovarian cancer incidence rate for Aboriginal and Torres Strait Islander females decreased from 12.2 to 11.0 new cases per 100,000 females.5
From 2006–2010 to 2011–2015, the age-standardised pancreatic cancer incidence rate for Aboriginal and Torres Strait Islander people increased from 13.8 to 17.2 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate increased from 12.5 to 18.4 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate increased from 14.1 to 16.3 per 100,000 females. 5
From 2006–2010 to 2011–2015, the age-standardised prostate cancer incidence rate for Aboriginal and Torres Strait Islander males decreased from 130.8 to 111.2 new cases per 100,000 males. 5
From 2006–2010 to 2011–2015, the age-standardised cancer of unknown primary incidence rate for Aboriginal and Torres Strait Islander people decreased slightly from 20.2 to 18.0 new cases per 100,000 persons. Among Aboriginal and Torres Strait Islander males, the age-standardised incidence rate decreased from 22.3 to 18.1 per 100,000 males. Among Aboriginal and Torres Strait Islander females, the age-standardised incidence rate decreased slightly from 17.9 to 17.8 per 100,000 females. 5
From 2006–2010 to 2011–2015, the age-standardised uterine cancer incidence rate for Aboriginal and Torres Strait Islander females increased from 26.5 to 28.0 new cases per 100,000 females. 5
Barriers and Opportunities
It is important to understand how many Aboriginal and Torres Strait Islander people in Australia are diagnosed with cancer, overall and by cancer type. Reporting of Aboriginal and Torres Strait Islander status within cancer registries sets is essential to gaining a complete picture of how many Aboriginal and Torres Strait Islander people are affected by cancer in Australia. This is an ongoing challenge and ongoing efforts are required to ensure the accuracy and completeness of information collected.
Information about cancer incidence helps with targeting prevention and awareness activities among Aboriginal and Torres Strait Islander peoples, and among relevant health and community services, health workers and health professionals. Such activities are important to help reduce the risk of cancer and support timely and accurate diagnosis.
Modifiable risk factors for cancer include smoking, obesity, alcohol consumption, poor diet, low levels of physical activity and infections such as hepatitis B and C.7,8 Cancer outcomes may also be influenced by access to health services and participation in cancer screening programs. Risk of cancer among Aboriginal and Torres Strait Islander peoples is compounded by the interaction between risk factors and social and cultural determinants of health.9 Awareness and education strategies about cancer risk reduction strategies among Aboriginal and Torres Strait Islander peoples should take account of social and cultural factors.
About the data
Cancer incidence indicates the number of new cancers diagnosed during a specified time period. The major source of cancer incidence data is the Australian Cancer Database (ACD) which contains records of all primary, malignant cancers (except basal cell and squamous cell carcinomas of the skin) diagnosed in Australia since 1982.
All Australian states and territories have legislation that makes cancer a notifiable disease. Various designated bodies, i.e., institutions such as hospitals, pathology laboratories and registries of births, deaths and marriages, are required to report cancer cases and deaths to their jurisdictional cancer registries.
Each registry supplies incidence data annually to the AIHW under an agreement between the registries and the AIHW. These data are compiled into the ACD, the only repository of national cancer incidence data. The 2015 national incidence counts include estimates for NSW in place of actual data, which were not available at the time of publication.
Population
Population data for age-specific rates is sourced from the Australian Bureau of Statistics (ABS).10
Methodology
Age standardisation
Australian incidence data are age-standardised to the Australian population as at 30 June 2001 and are expressed per 100,000 population for “all ages combined” categories.5
Age specific rates (for age groupings of 0-14, 15-24, 25-34 years, etc) are calculated using the combined (2011 to 2015) estimated resident populations at 30 June or each year.5
Data source
Australian Cancer Database (ACD)
Data caveat
Consistent data on the diagnosis of cancer for Aboriginal and Torres Strait Islander people are not available nationally. All state and territory cancer registries collect information on Indigenous status; however, in some jurisdictions the methodological consistency of Indigenous status data is considered to vary too much for inclusion in national incidence analyses. Information in the ACD on Indigenous status is considered to be of sufficient consistency for New South Wales, Queensland, Western Australia and the Northern Territory. Data for these four jurisdictions therefore were used to examine the incidence of cancer by Indigenous status.
References
Activity in this area
Policy:
Cancer Australia. National Aboriginal and Torres Strait Islander Cancer Framework. 2015. Available from: https://www.canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/national-aboriginal-and-torres-strait-islander-cancer-framework
Cancer Australia. Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer. 2018 Available from: https://canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/optimal-care-pathway-aboriginal-and-torres-strait-islander-people-cancer
Data:
Australian Institute of Health and Welfare. Cancer Data in Australia. Web report. https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia (accessed November 2020)
Social Health Atlases of Australia: Population Health areas – Cancer Incidence data: https://phidu.torrens.edu.au/social-health-atlases/indicators-and-notes-on-the-data/social-health-atlases-of-australia-contents#cancer-incidence (accessed October 2017)
References
1. Australian Institute of Health and Welfare 2018. Cancer in Aboriginal and Torres Strait Islander people of Australia. Web report. Canberra: AIHW. https://www.aihw.gov.au/reports/cancer/cancer-in-indigenous-australians/contents/table-of-contents [Accessed November 2020]
2. Cancer Australia. For Aboriginal and Torres Strait Islander people. https://www.canceraustralia.gov.au/Aboriginal-and-Torres-Strait-Islander-people [Accessed November 2020]
3. Australian Institute of Health and Welfare 2020. Cancer Data in Australia. Web report. https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia [Accessed November 2020]
4. Australian Bureau of Statistics 2016. Estimates of Aboriginal and Torres Strait Islander Australians. Web Report. https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/estimates-aboriginal-and-torres-strait-islander-australians/jun-2016 [Accessed March 2021]
5. Australian Institute of Health and Welfare Australian Cancer Database [Accessed November 2020].
6. World Health Organisation ICD-10 online versions https://www.who.int/classifications/icd/icdonlineversions/en/ [Accessed 6 November 2020]
7. Australian Institute of Health and Welfare & Cancer Australia 2013. Cancer in Aboriginal and Torres Strait Islander people of Australia: an overview (Cancer series no. 78. Cat. no. CAN 75), AIHW, Canberra. https://www.aihw.gov.au/reports/cancer/cancer-in-indigenous-australians-overview/contents/table-of-contents [Accessed November 2020]
8. The Kirby Institute 2016. Bloodborne viral and sexually transmitted infections in Aboriginal and Torres Strait Islander people: surveillance and evaluation report 2016. The Kirby Institute, UNSW Australia, Sydney. https://kirby.unsw.edu.au/sites/default/files/kirby/report/ATSIP_2016-Aboriginal-Surveillance-Report_UPD170116.pdf [Accessed November 2020]
9. Australian Institute of Health and Welfare 2015. The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples 2015. Cat. no. IHW 147, AIHW, Canberra. https://www.aihw.gov.au/reports/indigenous-health-welfare/indigenous-health-welfare-2015/contents/table-of-contents [Accessed November 2020]
10. Australian Bureau of Statistics 2019. Estimates and Projections, Aboriginal and Torres Strait Islander Australians, 2006 to 2031 (ABS cat. no. 3238.0). Web Report. https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/estimates-and-projections-aboriginal-and-torres-strait-islander-australians/latest-release [Accessed March 2021]