Cancer survival can be used as an indicator of cancer prognosis at a population level as well as an indicator of effectiveness of treatments provided.1
The measure conditional 5-year relative survival (referred to as ‘conditional survival’ hereafter) can be used to answer questions like: "now that an individual has survived for X years, what is the probability of surviving another five years?”2 This indicator may be used at the population-level to provide a measure of the outcomes of management of people affected by cancer.2
About this measure
Survival from cancer is influenced by various factors, including demographic characteristics, tumour types, stages of cancers at diagnosis, other prognostic indicators and treatment. Cancer survival refers to the proportions of patients alive at specified points following cancer diagnosis, or from some designated point after diagnosis (conditional survival). It is commonly presented as the probability of surviving an additional specified amount of time, e.g., 5 or 10 years.1, 3
The conditional survival estimates in this analysis were derived from relative survival estimates for age and sex groupings. Conditional survival estimates analysed by Indigenous status or remoteness or socioeconomic status of residential area are presented for observed survival (rather than relative survival) due to limited availability of relevant life tables at time of publication.
Cancer survival statistics are made available by the Australian Institute of Health and Welfare (AIHW) for individual cancer types and groupings. These cancer types and groupings are classified using the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).1
Current status
Conditional survival for all cancers combined
In the period 2013–2017, the conditional 5-year survival for all cancers combined increased as the number of years already survived increased, from 1 year (82%) to 3 years (90%) and 5 years (92%).1 This shows that the longer a person has already survived after being diagnosed with cancer, the higher the likelihood of survival for another 5 years.
Age and sex
Conditional survival for all cancers combined was:
- Similar for males and females who had already survived 1, 3 or 5 years (males 82%, 90%, and 92%, respectively, and females 83%, 90% and 92.5% respectively).
- Similar for people in age groups less than 35 years, but gradually decreased thereafter with increasing age.
- Lowest for people aged 85 years and over who had already survived 1, 3 or 5 years (65.5%, 76% and 80%, respectively).
Males and females generally had similar conditional survival outcomes across the different age groups, except for people aged 85 years and over. Females in this age group had higher conditional survival than males for those who had already survived 1 year (69% compared to 62%), 3 years (79% compared to 73%); and 5 years (83% compared to 77%).
Aboriginal and Torres Strait Islander people
Conditional survival data for Aboriginal and Torres Strait Islander Australians are presented as observed survival from all causes of death rather than as relative survival from the cancer due to the limited availability of relevant life tables at time of publication.
In the period 2013–2017:
Conditional survival for all cancers combined among Aboriginal and Torres Strait Islander Australians was:
- Lower than for non-Indigenous persons among those who had already survived 1 year (64.5% compared to 72%);
- Closer to that for non-Indigenous persons among those who had already survived 3 years (75% compared to 78%) and 5 years (78% and 80%). Conditional survival was generally lower among males than females for both population groups.
For Aboriginal and Torres Strait Islander Australians, conditional survival among males for all cancers combined was:
- Lower than for females among those who had already survived 1 year (60% compared to 68%) and 3 years (71% compared to 78%);
- Lower than for females among those who had already survived 5 years (74% compared to 81%).
For non-Indigenous persons, conditional survival among males was:
- Lower than for females among those who had already survived 1 year (70% compared to 74[KC2] %), 3 years (76% compared to 81%), and 5 years (78% compared to 83%).
Differences in conditional survival by Indigenous status may be influenced by a number of factors, such as cancer stage at diagnosis, differences in treatment, prevalence of co-morbidities, and numbers of deaths from non-cancer causes.
Remoteness
Conditional survival by remoteness of residential area is presented using observed rather than relative survival due to the limited availability of relevant life tables at time of publication.
In the period 2013–2017, conditional survival for all cancers combined was similar across remoteness areas for people who had already survived 1 year (ranging between 72% and 74%).
In the period 2013–2017:
- Conditional survival for people living in Remote and Very Remote areas who had already survived 5 years (81.5%) was:
- Similar to that for people living in Major Cities (81.5%), Inner Regional areas (80%), or Outer Regional areas (80%).
Socioeconomic status (SES)
Conditional survival by SES areas is presented using observed survival rather than relative survival due to the absence of relevant life tables at the time of publication.
In the period 2013–2017:
- Conditional survival increased with increasing socioeconomic status from the lowest SES areas (SES1) to the highest SES areas (SES5) for all cancers combined, i.e.:
- From 70% to 77% for people who had already survived 1 year; and
- From 78% to 84% for people who had already survived 5 years.
Conditional survival generally increased with increasing socioeconomic status for both males and females.
Conditional survival by cancer type
In the period 2013–2017, for most of the 18 selected cancer types analysed (see Table 1 in ‘About the Data’), the probability of surviving at least 5 more years increased as the number of years already survived increased. The only exception was for prostate cancer, which had similarly high conditional survival regardless of the number of years already survived (between 96% and 97%).
Some cancer types had notable increases in survival if a person had already survived multiple years since being diagnosed with cancer. Cancers of the pancreas, brain, oesophagus, lung, liver, and unknown primary site had the largest increases in conditional survival prospects between 1 and 5 years following diagnosis. For each of these cancer types, conditional survival increased between 25 and up to 48 percentage points between 1 and 5 years following diagnosis.
Age and sex
In the period 2013–2017, conditional survival generally decreased with increasing age for the cancer types analysed. The ages at which decreases in conditional survival were observed and the extent to which these patterns were observed varied by cancer type.
In the period 2013–2017 for the cancer types analysed, conditional survival among males who had already survived:
- 1 year was:
- Lower than females for 13 of the 14 cancer types selected that affected both sexes, including cancers of the brain (36% compared to 41.5%), colon (79% compared to 81%), colorectal (78% compared to 81%), head and neck (including lip) (78% compared to 83%), lung (36% compared to 43%), melanoma of the skin (92% compared to 95%), non-Hodgkin lymphoma (84.5% compared to 87%), and rectum (76% compared to 79%).
- Higher than females for cancers of unknown primary site (62% compared to 56%).
- 5 years was:
- Similar to females for all of the cancer types analysed, with brain cancers showing the largest difference by sex (73.6% for males and 80% for females).
Aboriginal and Torres Strait Islander peoples
Conditional survival outcomes for Aboriginal and Torres Strait Islander Australians are presented using observed rather than relative survival due to the limited availability of life tables at the time of publication.
In the period 2013–2017, conditional survival outcomes for Aboriginal and Torres Strait Islander Australians were:
- Higher than for non-Indigenous persons among those who had already survived 5 years for bladder cancer (82% compared to 65%).
- Higher than for non-Indigenous persons among those who had survived 1 year for brain cancer (55% compared to 36%).
- Lower than for non-Indigenous persons among those with head and neck (including lip) cancers at 1 year (52% compared to 70%), at 3 years (62% compared to 75%), and at 5 years (64% compared to 76%).
- Lower than for non-Indigenous among those with colon and colorectal cancers at 1 year (colon: 61% compared to 67%; and colorectal: 61.5% compared to 67%).
- Lower than for non-Indigenous persons at 1 year (24% compared to 34.5%) and 3 years (41% compared to 53.5%) among those with lung cancer.
- [BJ3] Similar with differences attributable to chance compared with non-Indigenous persons among those who had already survived 1 year for bladder, melanoma of the skin, non-Hodgkin’s lymphoma, and rectal cancers.
- Similar with differences attributable to chance to non-Indigenous persons among those who had already survived 3 years for cancers of the bladder, brain, colon, colorectal, melanoma of the skin, non-Hodgkin’s lymphoma, rectal and unknown primary sites.
- Similar with differences attributable to chance to non-Indigenous persons among those who had already survived 5 years for cancers of the brain, colon, colorectal, lung, melanoma of the skin, non-Hodgkin’s lymphoma, and unknown primary sites.
- Not available due to small numbers by Indigenous status for cancers of the liver, oesophagus, and pancreas at 1, 3 and 5 years.
In the period 2013–2017, conditional survival among Aboriginal and Torres Strait Islander Australian males were:
- Lower than for non-Indigenous males among those who had already survived 1 year (50% compared to 69%) and 3 years (62% compared to 74%) for cancers of the head and neck (including lip).
- Lower than for non-Indigenous males among those who had already survived 1 year (78% compared to 84%), 3 years (76% compared to 83%) and 5 years (75% compared to 81%) for prostate cancer.
- Lower than for non-Indigenous males among those who had already survived 1 year (21% compared to 31%) and 3 years (38% compared to 50%) for lung cancer.
- Lower than for non-Indigenous males among those who had already survived 5 years for rectal cancer (63.5% compared to 77%).
- Similar or attributable to chance for non-Indigenous males among those who had already survived 1 year for bladder, colon, colorectal, melanoma of the skin, non-Hodgkin lymphoma, and cancers of the rectum.
- Similar or attributable to chance for non-Indigenous males among those who had already survived 3 years for cancers of the colon, colorectal, melanoma of the skin, non-Hodgkin lymphoma, and rectum.
- Similar or attributable to chance to non-Indigenous males among those who had already survived 5 years for cancers of the bladder, colorectal, head and neck (including lip), lung, melanoma of the skin, and non-Hodgkin lymphoma
- Due to small numbers, survival statistics were not available for comparison by Indigenous status for cancers of the brain (by sex), bladder (3-year survival for males), and unknown primary site (by sex). No survival data (1, 3 and 5 years) were available by Indigenous status for comparison for cancers of the liver, oesophagus, and pancreas.
In the period 2013–2017, conditional survival among Aboriginal and Torres Strait Islander Australian females were:
- Lower than for non-Indigenous females among those who had already survived 1 year for cancers of the breast (79% compared to 85.5%), colon (60% compared to 68.5%), lung (28% compared to 39%), and head and neck (including lip) (56% compared to 72%).
- Lower than for non-Indigenous females among those who had already survived 3 years after diagnosis for cancers of the colon (69% compared to 75%), lung (44% compared to 58%) and head and neck (including lip) (63% compared to 78%).
- Lower than for non-Indigenous females among those who had already survived 5 years after diagnosis for cancers of the breast (81% compared to 87%) and head and neck (including lip) (56% compared to 78%).
- Similar or attributable to chance compared with non-Indigenous males among those who had already survived 1 year for cancers of colorectum, melanoma of the skin, non-Hodgkin lymphoma, and rectum.
- Similar or attributable to chance compared with non-Indigenous females among those who had already survived 3 years for colon, breast, cervix, colorectal, melanoma of the skin, non-Hodgkin lymphoma, ovarian, rectal and uterine cancers.
- Similar or attributable to chance to non-Indigenous females among those who had already survived 5 years for cervical, colon, colorectal, melanoma of the skin, non-Hodgkin lymphoma, rectal and uterine cancers.
- Due to small numbers, survival statistics were not available for comparison by Indigenous status for cancers of the brain (by sex), bladder (female data) and 3-year survival (for males), unknown primary site (by sex), ovary (5-year survival), and lung (females 5-year survival). No survival data at 1, 3 and 5 years were available by Indigenous status for comparison for cancers of the liver, oesophagus, and pancreas.
Differences in survival by Indigenous status may have been influenced by a number of factors, such as cancer stage at diagnosis, differences in treatments, prevalence of co-morbidities, and numbers of deaths from non-cancer causes.3
Remoteness
Conditional survival by remoteness of residential area is presented using observed rather than relative survival due to a lack of ready availability of life tables at the time of publication.
- Conditional survival was generally higher for people who had already survived 1 year living in:
- Major Cities compared to other remoteness areas for cancers of the brain, head and neck (including lip) lung, liver and oesophagus.
- Remote and Very Remote areas compared to other remoteness areas for cancers of the bladder, colon, colorectal, and melanoma of the skin, and rectum.
- For people who had already survived 5 years, those living in Remote and Very Remote areas had generally higher conditional survival compared to those from other remoteness areas for cancers of the brain, colon, colorectal and, lung, and melanoma of the skin.
- For people who had already survived 5 years, conditional relative survival for all cancers combined, cancer of the rectum, and non-Hodgkin lymphoma was relatively stable, with a maximum range of 2 percentage points between regionalities.
Socioeconomic status (SES)
Conditional survival data by SES areas are presented using observed rather than relative survival due to the lack of ready availability of life tables at the time of publication.
- For people who had already survived 1 and 5 years after diagnosis, those living in the highest SES areas (SES 5) had higher conditional survival compared to those from other SES areas for the selected cancer types analyzed, except for cancers of the colon, colorectal, liver, oesophagus, and pancreas.
Trends
Trend data are not available.
About the data
Conditional relative survival refers to the probability of surviving a number of additional years (e.g., 5 years) after already surviving a specified period of time after cancer diagnosis (e.g. 1 year, 3 years or 5 years). Where possible, the conditional relative survival in this analysis was derived using relative survival. For more information on the calculation of conditional relative survival, refer to AIHW’s Cancer in Australia 2021.
Relative survival at diagnosis is defined as the ratio of the proportion of people who are alive following a specified amount of time (e.g., 1 year, 5 years or 10 years) after diagnosis of cancer (observed survival) to the proportion of people in the general population alive over the same time interval (expected survival), matched for age, sex and calendar year. Observed survival has been calculated from population-based cancer data. Expected survival has been calculated from life tables for the entire Australian population.1, 3
Relative survival was calculated using the period method for all reported time periods. This method calculates survival from a given follow-up or at-risk period. Survival estimates are based on the survival experience of people who were diagnosed before or during this period, and who were at risk of dying during this period. 1
International comparisons of cancer survival are generally not available, due to differences in cancer collection, coding, and reporting practices, as well as differences in the methodologies used for calculating survival.1
Table 1 presents relevant ICD-10 codes for all cancers combined and individual cancer types reported in this analysis.
Table 1. ICD-10 codes for all cancers combined and individual cancer types reported in this analysis
|
Cancer site/type |
ICD-10 codes |
|
All cancers combined |
C00-C96, D45-D46, D47.1, D47.3-D47.5, except 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 |
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 |
C19-20 |
|
Uterus |
C54-C55 |
Data source:
- All Australian states and territories have legislation that makes cancer a notifiable disease. Various designated bodies, e.g., hospitals, pathology laboratories and registries of births, deaths and marriages, are required to report cancer and cancer deaths to their jurisdictional cancer registries.
- Cancer survival data are made available by the Australian Institute of Health and Welfare (AIHW) for individual cancer types and cancer groupings. These cancer types and groupings are classified using ICD-10 codes.1
Data caveat:
- 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 included in C44.
- Conditional observed survival was calculated using the period method for the period 2013–2017. Note these data include estimates of incidence for the Northern Territory in 2017, death-certificate-only cases for New South Wales in 2017, and estimates for late registrations for Australia in 2017 and the Northern Territory in 2016. Estimated records are not included in calculations of the survival estimates presented.
- Remoteness areas are classified according to the 2016 Australian Statistical Geography Standard (ASGS) Remoteness Areas. Disaggregation by remoteness area is based on a hierarchical approach where a persons 2016 ASGS Statistical Area Level 1 (SA1) then Level 2 (SA2) of usual residence at time of diagnosis is used. 2011 ASGS SA2 are used for records registered in Tasmania and the Northern Territory. The accuracy of these classifications decreases over time due to changes in infrastructure within SA1/SA2 boundaries since 2016.
- Socioeconomic groups are classified according to the 2016 SEIFA quintile using the Index of Relative Socioeconomic Disadvantage (IRSD).
- All figures are rounded to whole numbers where relevant.
- Records with unknown age at the date of diagnosis were excluded from the analysis.
- Data presented by Indigenous status are inclusive of NSW, Vic, Qld, WA and NT combined.
References
Activity in this area
-
Australian Institute of Health and Welfare 2021. Cancer Data in Australia. Canberra: AIHW. https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/
-
Australian Institute of Health and Welfare 2021. Cancer in Australia 2021. Cancer series no.133. Cat. no. CAN 144. Canberra: AIHW.
References
-
Australian Institute of Health and Welfare. Cancer in Australia 2019. AIHW, Canberra, 2019.
-
Yu XQ, Baade PD and O'Connell DL. Conditional survival of cancer patients: an Australian perspective. BMC Cancer. 2012;12460.
-
National Cancer Institute USA. Population-based Cancer Survival Statistics Overview. https://surveillance.cancer.gov/survival/. Accessed: Jan 2017.
-
Australian Institute of Health and Welfare 2021. Cancer in Australia 2021. Cancer series no.133. Cat. no. CAN 144. Canberra: AIHW.
-
Yu XQ, Baade PD and O'Connell DL 2012. Conditional survival of cancer patients: an Australian perspective. BMC Cancer 12:460.
-
National Cancer Institute. Population-based Cancer Survival Statistics Overview. Bethesda: NCI; 2015 [Accessed January 2017]; Available at: https://surveillance.cancer.gov/survival/.