The mortality-to-incidence ratio (MIR) has been widely used as a data quality indicator in cancer registries. It also has been used to measure of the comparative efficacy of cancer control programs and surveillance as well as relationships between different health care systems (e.g., screening & treatment systems) and cancer outcomes.1-3 A positive association between lower health care system performance rankings and higher MIRs has been demonstrated by linear relationships between MIRs and health system rankings for five leading cancers (lung, colorectal, prostate, stomach, and breast cancer).3 MIR has also been used as an outcome indicator in comparisons across populations.2,4
Charts
About this measure
The mortality-to-incidence ratio (MIR) is calculated by dividing the mortality rate by the incidence rate, for the selected cancers and populations in a given year. In this report, the age-standardized rates (using the 2024 Australian population distribution) of mortality and incidence have been used. Mortality rates were obtained using the National Mortality Database (NMD).
The MIR is a ratio of two measures which change over time. It should be interpreted with caution, particularly when examining MIR trends. For instance, a decreasing MIR over time could reflect improvements in survival (decreasing mortality) or increased numbers of diagnoses (increasing recorded incidence), or a combination of both.5 Additional contextual information is required to interpret differences in MIR by cancer types and how these are changing over time.
Current status
In 2024, it is estimated that the mortality-to-incidence ratio (MIR) for all recorded cancers combined was 0.31. The highest MIRs applied for unknown primary site cancer (1.1), pancreatic cancer (0.84), liver cancer (0.81), and brain cancer and oesophageal cancer (both 0.8). The lowest MIRs were for melanoma of the skin (0.07) and colon cancer (0.11).
Males generally had higher MIRs for all recorded cancer types than females with exceptions for rectal cancer, liver and bladder cancer, where females had higher MIRs (0.72, 1.02 and 0.40 vs 0.64, 0.73 and 0.33, respectively). The MIRs for colon cancer and head and neck cancer including lips were the same in males and females.
All cancers combined
In 2024, the estimated mortality-to-incidence ratio (MIR) for all reported cancers combined was 0.31. The MIR for males was marginally higher than for females (0.33 vs 0.29).
Bladder cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for bladder cancer was 0.34. The MIR was higher in females than males (0.40 vs 0.33).
Brain cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for brain cancer was 0.80. The MIR for males was marginally higher than for females (0.82 vs 0.77).
Breast cancer in females
In 2024, the estimated mortality-to-incidence ratio (MIR) for breast cancer in females was 0.15.
Colorectal cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for colorectal cancer was 0.34. MIRs for males and females were very similar (0.35 vs 0.33).
Colon cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for colon cancer was 0.11. MIRs in males and females were similar at 0.11.
Rectal cancer (including rectosigmoid junction)
In 2024, the estimated mortality-to-incidence ratio (MIR) for rectal cancer was 0.67. The MIR for females was higher than for males (0.72 vs 0.64).
Head and Neck cancer (including lips)
In 2024, the estimated mortality-to-incidence ratio (MIR) for head and neck cancer including lip was 0.24. MIRs for males and females were similar at 0.24.
Liver cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for liver cancer was 0.81. The MIR for females was higher than for males (1.02 vs 0.73).
Lung cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for lung cancer was 0.59. The MIR for males was higher than for females (0.64 vs 0.54).
Melanoma of the skin
In 2024, the estimated mortality-to-incidence ratio (MIR) for melanoma of the skin was 0.07. The MIR for males was higher than for females (0.09 vs 0.05).
Non-Hodgkin lymphoma
In 2024, the estimated mortality-to-incidence ratio (MIR) for non-Hodgkin lymphoma was 0.26. MIRs for males and females were very similar (0.27 vs 0.25).
Oesophageal cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for oesophageal cancer was 0.80. The MIR for males was higher than for females (0.83 vs 0.78).
Pancreatic cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for pancreatic cancer was 0.84. MIRs for males and females were quite similar (0.85 vs 0.84).
Prostate cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for prostate cancer was 0.16.
Ovarian cancer
In 2020, the estimated mortality-to-incidence ratio (MIR) for ovarian cancer was 0.71.
Note: no data on the incidence of ovarian cancer were available from 2021.
Unknown primary site cancer
In 2024, the estimated mortality-to-incidence ratio (MIR) for Unknown cancer primary site was 1.1. The MIR for males was marginally higher than for females (1.13 vs 1.09).
Uterine cancer
In 2024, the estimated mortality-to-incidence ratio (MIR)for uterine cancer was 0.20.
Trends
All cancers combined
Between 1982 and 2024, the estimated MIRs for all reported cancers combined in Australia decreased substantially from 0.57 to an estimated 0.31. This pattern applied to both males and females. The estimated MIRs for all reported cancers combined in males and females decreased from 0.60 and 0.52 in 1982 to 0.33 and 0.29 in 2024, respectively.
Bladder cancer
From 1982 to 2024, the estimated MIRs for bladder cancer increased from 0.32 to 0.44 in 1996, varying between 0.39 and 0.44 to 2009 before decreasing to 0.34 in 2024. For males, the estimated MIRs increased from 0.33 in 1982 to a peak at 0.45 in 1995, then trending downwards to an estimated 0.33 in 2024. In females, the estimated MIRs trended upwards from 0.33 in 1982 to a peak at 0.60 in 2004, then decreasing to an estimated 0.40 in 2024.
Brain cancer
From 1982 to 2024, the estimated MIR for brain cancer marginally edged downwards from 0.83 in 1982 to 0.74 in 2005 before marginally increasing again to an estimated 0.80 in 2024. The MIRs for brain cancer in males decreased from a peak in 1983 of 0.99 to 0.77 in 2005 and remained relatively stable since then to an estimated 0.82 in 2024. Similarly for females, the MIRs marginally increased from 0.74 in 2008 to an estimated 0.77 in 2024 following a downward trend from the peaks of 0.92 and 0.95 in 1984 and 1990, respectively.
Breast cancer in females
Between 1982 and 2024, the MIRs for breast cancer in females substantially decreased from 0.39 to an estimated 0.15 in 2024.
Colorectal cancer
Between 1982 and 2024, the MIRs for colorectal cancer decreased from 0.57 to an estimated 0.34 in 2024 with a relative plateau at 0.34 since 2011. Over this period, this pattern was the same for males (from 0.59 to an estimated 0.35 with the relative plateau period since 2010 at 0.36) and for females (from 0.56 to an estimated 0.33 with the relative plateau period since 2011 at 0.33).
Colon cancer
Between 1982 and 2024, the MIRs for colon cancer substantially decreased from 0.64 to an estimated 0.11 in 2024. This pattern was the same for males (from 0.67 to an estimated 0.11) and females (from 0.61 to an estimated 0.11).
Rectal cancer (including rectosigmoid junction)
The MIRs for rectal cancer decreased from 0.41 to 0.28 in 1996, remaining quite stable until 2006 (at 0.30) before increasing to an estimated 0.67 in 2024. The pattern was the same in males and females with slightly different timing.
Head and Neck cancer (including lip)
Between 1982 and 2024, the MIRs for Head and neck cancer decreased from a peak in 1984 at 0.38 to an estimated 0.24 in 2024, with a marginal variation period since 2006 at 0.24. MIRs for males and females decreased from a peak of 0.39 in 1985 and 0.40 in 1984 to an estimated 0.24 in both sexes in 2024, with marginal variation periods since 2006 at 0.26 and 0.20 in males and females, respectively. The change was more inconsistent in females.
Liver cancer
Between 1982 and 2024, the MIRs for liver cancer decreased from a peak in 1983 at 1.65 to an estimated 0.81 in 2024. MIRs for males and females decreased from a peak of 1.53 in 1983 and 2.09 in 1984 to an estimated 0.73 and 1.02 in 2024, respectively.
Lung cancer
Between 1982 and 2024, MIRs for lung cancer decreased from 0.90 in 1995 to an estimated 0.59 in 2024, after a marginal variation since 1971 between 0.86 and 0.93. The pattern was the same in females where the MIRs decreased from 0.87 in 1995 to an estimated 0.54 in 2024 after only marginal variation since 1971. The MIRs in males gradually decreased from 0.94 to an estimated 0.64.
Melanoma of the skin
Between 1982 and 2024, MIRs for melanoma of the skin decreased from 0.19 in 1982 to 0.13 in 1996 and then remained stable to 2013 before decreasing again to an estimated 0.07 in 2024. This pattern applied to both sexes. The MIRs for males decreased from 0.24 in 1982 to an estimated 0.09 in 2024, with a quite stable period between 1995 and 2013 at around 0.16. The MIRs in females decreased from 0.13 in 1982 to an estimated 0.05 in 2024, with a relatively stable period between 1993 and 2012 at around 0.10.
Non-Hodgkin lymphoma
Between 1982 and 2024, the MIRs for non-Hodgkin lymphoma approximately halved from 0.59 in 1982 to an estimated 0.26 in 2024. The pattern was similar in males and females with the MIRs decreasing from 0.63 and 0.55 in 1982 to an estimated 0.27 and 0.25 in 2024, respectively.
Oesophageal cancer
Between 1982 and 2024, the MIRs for oesophageal cancer trended downwards from 1.02 in 1982 to an estimated 0.8 in 2024. Over the same period, the MIRs for males decreased from 1.12 in 1982 to an estimated 0.83 in 2024, whereas for females there was a marginal variation between 0.88 in 1982 and an estimated 0.78 in 2024.
Pancreatic cancer
Between 1982 and 2024, the MIRs for pancreatic cancer decreased from 0.98 in 1982 to an estimated 0.84 in 2024. Over the same period, the MIRs in males and females marginally decreased from 0.98 in 1982 to an estimated 0.85 and 0.84 in 2024, respectively.
Prostate cancer
Between 1982 and 2024, the MIRs for prostate cancer decreased markedly from 0.44 in 1989 to the 2 lowest points in 1994 (at 0.25) and 2008 (at 0.17), then stabilizing at an estimated 0.16 in 2024.
Ovarian cancer
From 1982 to 2020, the MIRs for ovarian cancer marginally changed between 0.74 in 1982 and an estimated 0.71 in 2020.
Note: no data on the incidence of ovarian cancer were available from 2021 onwards.
Unknown primary site cancer
Between 1982 and 2024, the MIRs for cancer of unknown primary site increased from 0.57 in 1982 to an estimated 1.1 in 2024, with a pronounced increase occurring between 2001 and 2008 (from 0.75 to 1.18). This pattern was similar for males and females.
Uterine cancer
Between 1982 and 2024, the MIRs for uterine cancer edged downwards from 0.26 in 1982 to an estimated 0.20 in 2024 with the most pronounced decrease occurring between 1985 and 2000 (from 0.3 to 0.17).
About the data
Cancer is classified by the International Statistical Classification of Diseases and Related Health Problems Version 10 (ICD–10). This is a statistical classification, published by the World Health Organization, in which each morbid condition is assigned a unique code according to established criteria. The cancers in the ACD are coded using the 2nd revision of the 3rd edition of the International Classification of Diseases for Oncology (ICD-O-3.2). The ICD-O-3.2 codes can be mapped to the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). All reported cancers combined incorporate ICD-10 cancer codes C00–C96 with mortality also incorporating C97, D45 (polycythaemia), D46 (myelodysplastic syndromes), and D47.1, D47.3, D47.4 and D47.5 (myeloproliferative diseases).8
References
Data source
- Australian Institute of Health and Welfare 2024. Cancer data in Australia. Data. Canberra: AIHW. Accessed Dec 2024; https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/data
References
- Adams SA, Choi SK, Khang L, et al. Decreased cancer mortality-to-incidence ratios with increased accessibility of federally qualified health centers. J Community Health. 2015 Aug;40(4):633-41.
- Sunkara V, Hébert JR. The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care. Cancer. 2015 May 15;121(10):1563-9.
- Choi E, Lee S, Nhung BC, et al. Cancer mortality-to-incidence ratio as an indicator of cancer management outcomes in Organization for Economic Cooperation and Development countries. Epidemiol Health. 2017 Feb 5;39:e2017006.
- Hébert JR, Daguise VG, Hurley DM, et al. Mapping cancer mortality-to-incidence ratios to illustrate racial and sex disparities in a high-risk population. Cancer. 2009 Jun 1;115(11):2539-52.
- Zhizhilashvili S, Mchedlishvili I, Camacho R, et al. Descriptive Epidemiology of Gastric Cancer: A Population-Based Study From Georgia. Cureus. 2024 Aug 14;16(8):e66862.
- Australian Institute of Health and Welfare 2024. Cancer data in Australia. Web report. Cat. no. CAN 122. Canberra: AIHW. Accessed Dec 2024; https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/about
- Australian Institute of Health and Welfare 2024. Cancer data in Australia. Data. Canberra: AIHW. Accessed Dec 2024; https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/data
- Australian Institute of Health and Welfare 2024. Cancer data in Australia. Methods; Canberra: AIHW. Accessed Dec 2024; https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/technical-notes/methods