Published 23 Sep, 2021

Around half of Aboriginal and Torres Strait Islander people (47%) survived for five years or longer after their cancer diagnosis in 2012–2016.1

Cancer survival (observed survival) describes the percentage of people with cancer who are alive at a defined period of time after their diagnosis. The most common timeframe within which cancer survival is measured is five years. Five-year survival describes the likelihood of living for five years or more after being diagnosed with cancer. For example, if 6 in 10 people with cancer are alive five years after their diagnosis, cancer survival is 60%.

Cancer survival increases when cancers are diagnosed at an early stage (i.e. before cancer has spread to other parts of the body). This means that treatment is more likely to be effective. Cancer survival is also improving over time for many cancers with improvements in diagnostic technology and cancer treatments.2

While Australia’s cancer survival rates are among the best in the world, Aboriginal and Torres Strait Islander peoples continue to experience disparities in cancer outcomes. Cancer survival rates are lower for Aboriginal and Torres Strait Islander peoples than for the general population. Between 2012 and 2016 in Australia, five-year cancer survival was higher among Aboriginal and Torres Strait Islander women than men: 51% of Aboriginal and Torres Strait Islander women were alive five years or longer after diagnosis, compared with 42% of Aboriginal and Torres Strait Islander men.

Cancer survival among Aboriginal and Torres Strait Islander peoples varies by cancer type. Between 2012 and 2016, about three-quarters of Aboriginal and Torres Strait Islander people diagnosed with melanoma, breast and uterine cancer (in women) and prostate cancer (in men) were alive five years or longer after diagnosis. For Aboriginal and Torres Strait Islander people diagnosed with liver or lung cancer, fewer than 10% of people were alive five years or longer after diagnosis.  

    Charts
    • Notes
      • Data sourced from AIHW Cancer Database 2016.
      • Data are for NSW, Qld, WA and NT only. The period reported does not contain incidence data for 2016 for the NT because those data were not available.
      • Error bars represent 95% confidence intervals.
      • “Australia total” group excludes records where Aboriginal and Torres Strait Islander status was not stated.
      • When presenting data of Australian Aboriginal and Torres Strait Islander people we will be respectfully using the term Indigenous Australians.
      Table caption
      5-year observed survival rate for selected cancers and all cancers combined in Aboriginal and Torres Strait Islander people, by sex, 2012–2016

    This measure presents cancer survival data for Aboriginal and Torres Strait Islander peoples from four states and territories: New South Wales, Queensland, Western Australia and the Northern Territory. Data are for the period 2012–2016 (excluding data for the NT for 2016; data were not available for this year).

    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 and cancer deaths to the cancer registry is required by law. National data, using data from each state and territory, is collated in the Australian Cancer Database, which is maintained by the Australian Institute of Health and Welfare (AIHW).1

    Data about cancer survival among Aboriginal and Torres Strait Islander peoples in Australia relies on information being collected in the registries about whether a person diagnosed with cancer or who dies from cancer identifies (or identified) as Aboriginal or Torres Strait Islander. While every registry collects information about Aboriginal and Torres Strait Islander status, the quality of this information varies. Currently, registries in four states and territories contain information about Aboriginal and Torres Strait Islander status considered to be of a consistent and high enough quality for inclusion in national reports and analyses: New South Wales, Queensland, Western Australia and the Northern Territory.

    Cancer types

    Data about cancer survival are published by the AIHW for individual cancer types and cancer groupings. Tumour types and groupings are classified by ICD-10 code.3 Cancer survival data exclude basal and squamous cell carcinomas of the skin.

    Survival (chances of living after cancer diagnosis) in Aboriginal and Torres Strait Islander people, by sex

    • Almost half of Aboriginal and Torres Strait Islander people (46.7%) survived for five years or longer after a cancer diagnosis in 2012–2016.
    • Survival was lower for males (42.4%) than females (51%).

    Survival (chances of living after cancer diagnosis) in Aboriginal and Torres Strait Islander people, by sex and type

    • Survival was highest for melanoma (73.3%), breast cancer (76.8%) and uterine cancer (75.1%) in females and prostate cancer (77.6%) in males. About three-quarters of Aboriginal and Torres Strait Islander people diagnosed with one of these cancer types lived for five years or longer after cancer diagnosis.
    • Survival was lowest for cancers of the lung (9.4%), liver (9.1%) and unknown primary site (4.5%). Less than 10% of Aboriginal and Torres Strait Islander people with these cancers lived five years or longer after their cancer diagnosis.

    Barriers and Opportunities

    Cancer survival is dependent on various factors, including individual patient demographics, cancer type, stage at diagnosis, other co-morbidities and risk factors, and availability of and access to treatment.

    A range of factors are likely to contribute to the disparities in cancer survival seen among Aboriginal and Torres Strait Islander peoples. Diagnosis of cancer at a more advanced stage may mean that treatment options are limited or more complex. Treatment options may also be compromised by co-morbidities. These issues are compounded by the barriers that Aboriginal and Torres Strait Islander people may experience in accessing health services as well as fear and mistrust of the health system.4

    The Optimal care pathway for Aboriginal and Torres Strait Islander people with cancer5 highlights the importance of timely diagnosis of cancer in improving cancer survival. It also highlights that culturally safe services and a culturally competent workforce able to address the needs of Aboriginal and Torres Strait Islander people are key factors in improving cancer outcomes.

    More information

    Aboriginal and Torres Strait Islander identification in national cancer data

    Optimal care pathway for Aboriginal and Torres Strait Islander people with cancer

    National Aboriginal and Torres Strait Islander Cancer Framework

     

    Methodology:

    Survival is interpreted in this report as the percentage of people still alive after a specified period of time from diagnosis with cancer (observed survival). It is commonly described as the chance of living for five (or ten) years or more after being diagnosed.1,6 For example, if 6 in 10 people with cancer are alive 5 years after their diagnosis, observed survival would be 0.6 or 60%.

    Table 1 presents relevant ICD-10 codes for all cancers combined and individual cancer types reported in this analysis.

     

    Table 1. ICD codes for all cancers combined and individual cancer types

    Cancer site/type

    ICD-10 codes

    All cancers combined

    C00-C96, D45-D46, D47.1, D47.3-D47.5, except for basal and squamous cell carcinomas of the skin which are part of C44

    Bladder

    C67

    Brain

    C71

    Breast in females

    C50

    Cancer of unknown primary site

    C80

    Cervix

    C53

    Colon

    C18

    Colorectal

    C18-20

    Head and neck (including lip)

    C00-C14, C30-C32

    Liver

    C22

    Lung

    C33-C34

    Melanoma of the skin

    C43

    Non-Hodgkin Lymphoma

    C82-C86

    Oesophageal

    C15

    Ovary

    C56

    Pancreas

    C25

    Prostate

    C61

    Rectum

    C19-C20

    Uterus

    C54-C55

     

    Data source:

    • All Australian states and territories are required by law to report cancer. Organisations – such as hospitals, pathology laboratories and registries of births, deaths and marriages – are required to report cancer to the relevant state or territory cancer registry.
    • Survival statistics are made available by the Australian Institute of Health and Welfare (AIHW) for individual cancer types and cancer groupings. These cancer types and cancer groupings are classified using the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).3
    • Aboriginal and Torres Strait Islander data are sourced from an updated data extract and analysis prepared by the AIHW at the request of Cancer Australia and include observed survival data for 2012-2016.1

     

    Data caveats:

    • All cancers combined include 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.
    • The period reported does not contain incidence data for 2016 for the NT because those data were not available
    • Data are for NSW, Qld, WA and NT only. The information on Aboriginal and Torres Strait Islander status in these jurisdictions is considered to be sufficiently consistent for reporting.1
    • Data are not presented for all persons (males, females and persons) for oesophageal and pancreatic cancers, bladder (females), brain (males and females), and liver (males and females) cancers due to small numbers.

     

    Activity in this area

    Data:

    Australian Institute of Health and Welfare 2020. Australian Cancer Database 2016. Canberra: AIHW.

    Australian Institute of Health and Welfare 2020. National Mortality Database. Canberra: AIHW.

    Policy:

    Australian Government Department of Health. National Aboriginal and Torres Strait Islander Health Plan 2013–2023. Available from: https://www.health.gov.au/resources/publications/national-aboriginal-and-torres-strait-islander-health-plan-2013-2023 (accessed September 2021)

     

    References

    1.  Australian Institute of Health and Welfare Australian Cancer Database [Accessed November 2020].

    2. Australian Institute of Health and Welfare 2019. Cancer in Australia 2019. Cancer series no.119. Cat. no. CAN 122. Canberra: AIHW.

    3. World Health Organisation ICD-10 online versions [Accessed 6 November 2020] https://www.who.int/classifications/icd/icdonlineversions/en/  

    4. Cancer Australia. 2014. Review and collation of evidence on programs improving cancer outcomes in Aboriginal and Torres Strait Islander People Project. Health Outcomes Australia, Glynde, SA.

    5. Cancer Australia. 2018. Optimal care pathway for Aboriginal and Torres Strait Islander people with cancer. Surry Hills: Cancer Australia. https://www.canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/optimal-care-pathway-aboriginal-and-torres-strait-islander-people-cancer [Accessed November 2020]

    6. National Cancer Institute. Population-based Cancer Survival Statistics Overview. Bethesda: NCI; 2020; Available at: https://surveillance.cancer.gov/survival/ [accessed February 2020]

     

    Summary

    Survival following a cancer diagnosis (chances of living after diagnosis) in Aboriginal and Torres Strait Islander people

    Around half of Aboriginal and Torres Strait Islander people (46.7%) survived for five years or longer after their cancer diagnosis in 2012-2016.