Introduction

Data on cancer incidence are collected by state and territory Population-based Cancer Registries (PBCRs) and mortality data are sourced from the National Mortality Database (NMD). These data are aggregated at a national level and are published by the Australian Institute of Health and Welfare (AIHW).

The need for high quality, comprehensive national data on the stage (severity) of cancer at diagnosis, the treatments applied to cancers and the frequency of recurrence of cancer after treatment to supplement these data is widely recognised.

The analysis and reporting of cancer treatment data would greatly enhance our ability, as a nation, to better understand cancer care and outcomes in context to the treatments being applied across population groups. 

Scope

Cancer Australia - in collaboration with leading national, state and territory health organisations and governments - is developing methods to improve the collection, collation and analysis of cancer-specific population health data through the Stage, Treatment and Recurrence (STaR) project.¹ The STaR treatment data will initially focus on the five highest incidence cancers in Australia (excluding non-melanoma skin cancers), i.e: cancers of the prostate, breast, colon and rectum, lung, and melanoma (skin). A dataset of key selected surgical procedures for the treatment of these five cancers has been developed.  

In addition, a dataset of key selected radiotherapy, and systemic therapies for the treatment of all cancer types has been developed.

The data presented on the NCCI website presently includes:

• key selected surgical procedures for the treatment of the top five incidence cancers
• key selected radiotherapy, and systemic anti-cancer therapies for the treatment of all cancer types combined.

The data reported here provide a high-level national system overview of these cancer treatments.

The data are not exhaustive for all cancer treatments, but provide for the first time, a focus on the key cancer treatments.

For the purposes of the analyses, cancer related treatments presented include: “key selected surgical procedures, radiotherapy procedures, or pharmaceutical agent(s) administered, with the general intent to change the outcome of the cancer and/ or provide symptom relief/palliative care”.

Specifically, these initial data provide a national overview of:

• the number of radiotherapy services provided for all cancers combined in Australia (as indicated by Medicare Benefits Schedule (MBS) reimbursement claims data) for the years 2013 to 2015 inclusive;
• the number of people receiving systemic therapies in Australia for all cancers combined (as indicated by Pharmaceutical Benefits Scheme (PBS) reimbursement claims data) for the years 2012 to 2016 inclusive; and
• the number of hospital separations (i.e. episodes of admitted patient care) for patients with a principal diagnosis of cancer undergoing surgery for the treatment of the top five high incidence cancers in Australia (as recorded in the National Hospital Morbidity Database (NHMD)), for the years 2010 to 2015 inclusive.

Due to differences in the age structures of the Aboriginal and Torres Strait Islander and non-Indigenous Australian populations, surgical treatment activity data for these groups have been examined separately using age standardisation methods on the 'Surgical treatment activity for Aboriginal and Torres Strait Islander Peoples' page. Data on radiotherapy and systemic therapy treatment by Indigenous status were not available at the time of analysis.

Data sources

Data for these indicators were extracted from existing national health datasets, including: the PBS, the MBS and the NHMD (held by the Australian Institute of Health and Welfare). Data for treatment activity indicators are sourced from:

• Surgical treatment activity – NHMD and MBS (for some melanoma-related procedures)
• Radiotherapy – MBS
• Systemic anti-cancer therapies –  PBS

The initial data for surgery relate to hospital separations data, radiotherapy relate to MBS claims data, and systemic therapies relate to PBS claims data. These data do not represent individual patients, because an individual may have more than one treatment episode related for their cancer in a given year. Therefore the data provide a system-wide summary of the numbers of key procedures and therapies provided for cancer treatments provided in Australia.

Specific information about sources of system-wide treatment data, and guidance for interpreting the data, can be found in the ‘About the Data’ tab and definitions of key terms for treatment indicators are provided in the ‘Glossary’ page.

Future reporting

More detailed treatment data will be provided on the NCCI website as the STaR project progresses. The next major phase of the STaR project will build upon this initial reporting by examining population-level treatment pathways through linking treatment data to data on cancer incidence and stage (the severity of cancer at diagnosis). More information about the STaR project can be found here.

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[1]. Coad E. 2016. Cancer control’s new STaR. Med J Aust 2016; 205 (4): 145.