Cancer in Aboriginal and Torres Strait Islander people of Australia

The following material has been sourced from the Australian Institute of Health and Welfare

The following information describes the incidence, mortality, survival and prevalence of cancer in Aboriginal and Torres Strait Islander people of Australia. The ICD-10 cancer codes associated with 'all cancers combined' and individual cancer sites can be found on their respective pages.

The main data sources for this web page are the 2012 Australian Cancer Database (ACD) and the 2013 National Mortality Database (NMD). The 5-year period of incidence data (2006 to 2010) and mortality data (2009 to 2013) was used for this web page because 2010 and 2013 were the latest years for which actual data were available respectively.


Number of new cancer cases diagnosed in Indigenous Australians, 2006–2010

4,669 = Male icon PNG 2,303 males + Female icon PNG 2,366 females


Number of deaths from cancer in Indigenous Australians, 2009–2013

2,417 = Male icon PNG 1,264 males + Female icon PNG 1,153 females


cancer survival 5 years PNG

Chance of surviving at least 5 years (2008–2012)

43%


Lots of people PNG

Indigenous Australians living with cancer at the end of 2010 (diagnosed in the 5 year period 2006 to 2010)

2,558


Key findings

The age-standardised incidence rate for all cancers combined is lower for Indigenous Australians than non-Indigenous Australians; however, the mortality rate is significantly higher for Indigenous Australians. The higher mortality rate may be partly due to Indigenous Australians generally have poorer access to health-care services and are more likely to have cancers that are diagnosed at a later stage than non-Indigenous Australians [1, 2].

How common is cancer in Aboriginal and Torres Strait Islander people?

Reliable national data on the diagnosis of cancer for Indigenous Australians are not available. All state and territory cancer registries collect information on Indigenous status; however, in some jurisdictions the quality of Indigenous status data is insufficient for analyses. Information in the ACD on Indigenous status is considered to be of sufficient completeness for reporting for New South Wales, Queensland, Western Australia and the Northern Territory. Data for these four jurisdictions were used to examine the incidence of cancer by Indigenous status.

In 2006–2010, there were 4,669 new cases of  cancer diagnosed in Indigenous Australians (2,303 males and 2,366 females).a During the same period, 315,427 new cases of cancer were diagnosed in non-Indigenous Australians.b

In 2006–2010, the age-standardised incidence rate for Indigenous Australians was 446 cases per 100,000 persons (508 for males and 401 for females). The age-standardised incidence rate for non-Indigenous Australians during the same period was 450 cases per 100,000 persons (543 for males and 373 for females).

Figure 1: Age-specific incidence rates for cancer in Indigenous and non-Indigenous Australians, New South Wales, Queensland, Western Australia and the Northern Territory, 2006–2010

bar graph showing the number of new cases of all cancers combined in Indigenous and non-Indigenous Australians during the period 2006-2010 in New South Wales, Queensland, Western Australia and the Northern Territory, by five year age groups (0-4 to 85+). The age-standardised incidence rate for each five year age group is expressed as the number of new cases of all cancers combined diagnosed per 100,000 persons, which is presented on the y-axis. The incidence rate of all cancers combined during 2006-2010 in Indigenous Australians increased from 15.5 cases per 100,000 in those aged 0-4, to 2,689.4 cases per 100,000 in those aged 85+. During the same period, for non-Indigenous Australians, the incidence rate of all cancers combined increased from 21.5 cases per 100,000 in those aged 0-4 to 2,494.4 cases per 100,000 in those aged 85+.

Source: AIHW analysis of the Australian Cancer Database, (see source table 1).

During 2006–2010, the 10 most commonly diagnosed cancers among Indigenous Australians accounted for approximately 69% of all cancers diagnosed within this population. Eight of the 10 most diagnosed cancers were common to both Indigenous and non-Indigenous Australians. However, the top 10 cancer incidence rankings for Indigenous Australians differed from those for non-indigenous Australians (see Table 1 below). Cancer types that were ranked higher in the Indigenous population than in the non-Indigenous population include:

  • Lung cancer (ranked 1st compared with 4th)
  • Gynaecological cancer among females (ranked 4th compared with 7th)
  • Uterine cancer among females (ranked 7th compared with 15th)
  • Liver cancer (ranked 10th compared with 18th)

Conversely, the incidence of prostate and bowel cancers as well as lymphoma were ranked higher in non-Indigenous Australians than in Indigenous Australians.

Table 1: The 10 most commonly diagnosed cancers in Aboriginal and Torres Strait Islander people of Australia, New South Wales, Queensland, Western Australia and the Northern Territory, 2006-2010.
Cancer site (ICD-10 code) Indigenous
Australians
Number of new cases
Indigenous
Australians
Rank
Indigenous
Australians
ASR
non-Indigenous Australians
Number of new cases
non-Indigenous Australians
Rank
non-Indigenous Australians
ASR
Lung (C33–34) 706 1 77.1 30,723 4 43.7
Breast (C50) 542 2 85.6 39,160 3 109.5
Bowel (C18-20) 442 3 46.8 41,888 2 59.6
Gynaecological cancer (C51–C58) 423 4 51.1 13,030 7 25.9
Prostate (C61) 377 5 98.0 54,482 1 160.7
Head and neck
(C00–14,C30–32)
359 6 28.0 10,971 8 15.7
Uterine (C54–55) 166 7 27.1 5,702 15 15.6
Unknown primary
(C77–80, C97)
166 8 19.1 7,658 10 10.7
Lymphoma
(C81–86)
158 9 13.5 13,249 6 19.1
Liver (C22) 154 10 15.6 3,962 18 5.7

Notes

  1. Breast, Gynaecological and Uterine cancer age-standardised rates are expressed per 100,000 females.
  2. Prostate cancer age-standardised rates are expressed per 100,000 males.

Deaths from cancer in Aboriginal and Torres Strait Islander people

Information in the NMD on Indigenous status from 2009 to 2013 is considered to be of sufficient quality for use for five jurisdictions: New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Data for these five jurisdictions are used to examine mortality of cancer by indigenous status.

In 2009–2013, there were 2,417 deaths from cancer among Indigenous Australians (1,264 males and 1,153 females).c During the same period, there were 149,542 deaths from cancer among non-Indigenous Australians (85,324 males and 64,218 females).d  

In 2009-2013, the age-standardised mortality rate among Indigenous Australians was 221 deaths per 100,000 persons (260 for males and 193 for females). During the same period, the age-standardised mortality rate was 170 deaths per 100,000 persons for non-Indigenous Australians (217 for males and 134 for females).

In 2009–2013, age-specific mortality rates from cancer were higher for Indigenous Australians for age groups 20–24 to 75–79. The age-specific mortality rate was higher in non-Indigenous Australians in all other age groups (see figure below).

Figure 2: Age-specific mortality rates for cancer, New South Wales, Queensland, Western Australia, South Australia and the Northern Territory, 2009–2013

bar graph showing the number of deaths due to all cancers combined in Indigenous and non-Indigenous Australians during the period 2009-2013 in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory, by five year age groups (0-4 to 85+). The age-standardised mortality rate for each five year age group is expressed as the number of deaths per 100,000 persons, which is presented on the y-axis. The mortality rate of all cancers combined during 2009-2013 in Indigenous Australians increased from 1.4 deaths per 100,000 in those aged 0-4, to 1,662.6 deaths per 100,000 in those aged 85+. During the same period, for non-Indigenous Australians, the mortality rate of all cancers combined increased from 2.1 deaths per 100,000 in those aged 0-4 to 2,138.8 deaths per 100,000 in those aged 85+.

Source: AIHW analysis of the Australian Cancer Database, (see source table 2).

During 2009–2013, the 10 most common causes of cancer deaths among Indigenous Australians accounted for approximately 75% of all cancers deaths in this population. Lung cancer was the most common cause of cancer death for both Indigenous and non-Indigenous Australians. Similarly, 7 cancer types were in the top 10 mortality rankings for both Indigenous and non-Indigenous Australians. However, the order of the cancer mortality rankings differed between Indigenous and non-Indigenous Australians (see Table 2 below). Cancer types that were ranked higher in the Indigenous population include:

  • Head and neck cancer (ranked 2nd compared with 17th)
  • Liver cancer (ranked 3rd compared with 11th)
  • Oesophageal cancer (ranked 9th compared with 14th)

Conversely, bowel cancer, prostate cancer in males, breast cancer in females and pancreatic cancer were ranked higher among non-Indigenous Australians than in Indigenous Australians.

Table 2: The 10 most common cancer deaths in Aboriginal and Torres Strait Islander people of Australia, New South Wales, Queensland, Western Australia, South Australia and the Northern Territory, 2009–2013.
Cancer site (ICD-10 code) Indigenous Australians
Number of deaths
Indigenous Australians
Rank
Indigenous Australians
ASR
non-Indigenous Australians
Number of deaths
non-Indigenous Australians
Rank
non-Indigenous Australians
ASR
Lung (C33–34) 610 1 57.0 28,523 1 32.7
Head and neck
(C00–14,C30–32)
177 2 13.9 3,532 17 4.0
Liver (C22) 176 3 15.8 4,865 11 5.6
Unknown primary site
(C77–80,C97)
169 4 16.7 9,707 5 10.9
Breast (C50) 143 5 21.9 9,725 4 21.0
Gynaecological cancers (C51–58) 135 6 19.2 5,745 7 12.3
Bowel (C18–20) 133 7 12.6 13,650 2 15.5
Pancreas (C25) 128 8 11.6 8,371 6 9.5
Oesophagus (C15) 109 9 8.4 4,144 14 4.7
Prostate (C61) 80 10 24.6 11,077 3 29.2

Notes

  1. Breast and gynaecological cancer age-standardised rates are expressed per 100,000 females.
  2. Prostate cancer age-standardised rates are expressed per 100,000 males.

Survival from cancer for Aboriginal and Torres Strait Islander peoplee, f, g

Aboriginal and Torres Strait Islander people diagnosed with cancer between 2008 and 2012 had a 43% chance of surviving 5 years after a cancer diagnosis. Indigenous Australians had a significantly lower 5-year crude survival than non-Indigenous Australians (43% compared with 57%).h

Prevalence of cancer in Aboriginal and Torres Strait Islander people of Australia

The prevalence for 1, 3 and 5 years given below are the number of Indigenous Australians  living with cancer at the end of 2010 who had been diagnosed in the preceding 1, 3 and 5 years respectively. i, j

One year prevalence

At the end of 2010, there were 840 Indigenous Australians (398 males and 442 females) living in New South Wales, Queensland, Western Australia and the Northern Territory who had been diagnosed with cancer that year. During the same period, there were 54,156 non-Indigenous Australians (30,147 males and 24,009 females) living in New South Wales, Queensland, Western Australia and the Northern Territory who had been diagnosed with cancers that year.

One year age-standardised prevalence was lower among Indigenous Australians (339 per 100,000) than non-Indigenous Australians (363 per 100,000).

Three year prevalence

At the end of 2010, there were 1,860 Indigenous Australians (841 males and 1,019 females) living in New South Wales, Queensland, Western Australia and the Northern Territory who had been diagnosed with cancer in the previous three years (from 2008 to 2010). During the same period, there were 139,716 non-Indigenous Australians (77,677 males and 62,039 females) living in New South Wales, Queensland, Western Australia and the Northern Territory who had been diagnosed with cancer in the previous three years (from 2008 to 2010).

Three year age-standardised prevalence was lower among Indigenous Australians (749 per 100,000) than non-Indigenous Australians (936 per 100,000).

Five year prevalence

At the end of 2010, there were 2,558 Indigenous Australians (1,170 males and 1,388 females) living in New South Wales, Queensland, Western Australia and the Northern Territory who had been diagnosed with cancer in the previous five years (from 2006 to 2010). During the same period, 207,720 non-Indigenous Australians (114,441 males and 93,279 females) were living in New South Wales, Queensland, Western Australia and the Northern Territory who had been diagnosed with cancer in the previous five years (from 2006 to 2010).

Five year age-standardised prevalence was lower among Indigenous Australians (1,033 per 100,000) than non-Indigenous Australians (1,392 per 100,000).


Source tables

Source table 1: Age-specific incidence rates for cancer in Indigenous and non-Indigenous Australians, New South Wales, Queensland, Western Australia and the Northern Territory, 2006–2010
Age group (years) Indigenous Australians non-Indigenous Australians
0–4 15.5 21.5
5–9 4.6 9.8
10–14 9.5 12.3
15–19 15.0 22.1
20–24 25.8 32.5
25–29 40.3 54.6
30–34 68.4 81.7
35–39 111.1 125.5
40–44 200.6 202.5
45–49 303.7 330.7
50–54 559.6 508.1
55–59 791.9 809.7
60–64 1,223.7 1,176.9
65–69 1,612.6 1,653.8
70–74 2,084.0 1,946.2
75–79 2,131.8 2,260.6
80–84 2,250.7 2,485.7
85+ 2,689.4 2,494.4

Notes

  1. Number of new cases per 100,000 persons.
Source table 2: Age-specific mortality rates due to cancer for Indigenous and non-Indigenous Australians, New South Wales, Queensland, Western Australia, South Australia and the Northern Territory, 2009–2013
Age group (years) Indigenous Australians non-Indigenous Australians
0–4 1.4 2.1
5–9 2.0 2.3
10–14 0.6 1.9
15–19 2.5 3.1
20–24 4.1 3.4
25–29 8.1 6.3
30–34 12.5 9.1
35–39 31.6 18.5
40–44 63.9 33.0
45–49 101.5 65.0
50–54 211.2 115.1
55–59 343.9 196.6
60–64 474.4 323.4
65–69 795.1 506.1
70–74 1167.1 764.7
75–79 1406.4 1,098.5
80–84 1508.8 1,562.0
85+ 1662.6 2,138.8

Notes

  1. Number of deaths per 100,000 persons.

Data notes

International Statistical Classification of Diseases and Related Health Problems Version 10 (ICD-10)

Cancer, like other health conditions, 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.

Incidence

Cancer incidence indicates the number of new cancers diagnosed during a specified time period.

  1. The 2006–2010 national incidence counts are considered of sufficient completeness for reporting New South Wales, Queensland, Western Australia and the Northern Territory.
  2. Comparisons have been made throughout with non-Indigenous Australians, with the analysis excluding those for whom Indigenous status was not given.

Mortality

Cancer mortality refers to the number of deaths occurring during a specified time period for which the underlying cause of death is cancer.

  1. The 2009–2013 national mortality counts are considered of sufficient completeness for reporting New South Wales, Queensland, Western Australia, South Australia and the Northern Territory.
  2. Comparisons have been made throughout with non-Indigenous Australians, with the analysis excluding those for whom Indigenous status was not given.

Survival

  1. Data provided are for cancer-related crude survival estimates for Aboriginal and Torres Strait Islander people for the period 2008–2012. Crude survival is the proportion of people alive at a specified point in time subsequent to the diagnosis of cancer.
  2. Crude survival estimates were calculated using the period method, instead of the cohort method, as it provides more up-to-date estimates of survival and is widely used among cancer registries.
  3. Information on Indigenous status is considered of sufficient completeness for reporting New South Wales, Queensland, Western Australia, the Northern Territory and Victoria.
  4. Comparisons have been made throughout with non-Indigenous Australians, with the analysis excluding those for whom Indigenous status was not given. Note that survival rates have not been age-standardised to the Australian population so any differences between the age structures of the two populations could affect comparisons.

Prevalence

Prevalence of cancer refers to the number of people alive with a prior diagnosis of cancer at a given time. It is distinct from incidence, which is the number of new cancers diagnosed within a given period of time.

  1. Information in the Australian Cancer Database on Indigenous status is considered of sufficient completeness for reporting for New South Wales, Queensland, Western Australia and the Northern Territory.
  2. Comparisons have been made throughout with non-Indigenous Australians, with the analysis excluding those for whom Indigenous status was not given.

Age standardised rates

  1. Incidence, mortality and prevalence rates expressed per 100,000 population are age-standardised to the Australian population as at 30 June 2001.

References

  1. Condon J, Armstrong B, Barnes T & Zhao Y 2005. Cancer in Indigenous Australians: a review. Cancer Causes Control 14:109–21.
  2. Threlfall TJ & Thompson JR 2009. Cancer incidence and mortality in Western Australia, 2007. Perth: Western Australian Department of Health.