Key findings In 2011:
• Australians lost 833,250 DALY due to premature death from cancer or living with cancer
• 94% of the burden was due to people dying prematurely, while only 6% of the burden was due to living with cancer
• lung cancer was associated with the highest proportion of the cancer burden, followed by colorectal cancer, breast cancer, prostate cancer and pancreatic cancer.
Burden of disease analysis measures the combined impact of fatal and non-fatal burden.
More than merely counting deaths or disease prevalence, it takes into account age at death and severity of disease. Burden of disease analysis quantifies the gap between a population’s actual health and an ideal level of health in a given year—that is, every individual living in full health to a theoretical maximum life span—for all diseases at the same time.
This chapter presents data on the burden of cancer, based on the Australian Burden of Disease Study (ABDS) 2011. The ABDS 2011 provides Australia-specific burden of disease estimates best matched to the Australian context for the total 2011 population. In the ABDS 2011, the cancer and other neoplasms disease group also includes the impact of benign, in situ and uncertain neoplasms. See Australian Burden of Disease Study: impact and causes of illness and death in Australia 2011 (AIHW 2016b) for more information.
Data are presented for the fatal burden, non-fatal burden and the overall burden. Fatal burden, which is expressed as years of life lost (YLL), measures the years lost between the age at which people die and the number of years they could have potentially gone on to live, based on the current best life expectancy across the world. Total YLL are influenced by both the number of deaths, and the ages at which the deaths occur.
Non-fatal burden, which is expressed as years lived with disability (YLD), measures the years of healthy life lost due to living with a disease in a given year. Total YLD are influenced by the number of people with each disease, the duration of its effects and how severe those effects are.
The overall burden, which is expressed as disability-adjusted life years (DALY), is the sum of YLL and YLD. One DALY is one year of ‘healthy life’ lost due to premature death or living with the effects of an illness or injury. The more DALY associated with a disease, the greater the burden.
7.1 All cancers combined
In 2011, Australians lost 4.5 million DALY due to premature death or living with disease or injury. Cancer (19% of total DALY) was the leading disease group, followed by
cardiovascular disease (15%) and mental and substance use disorders (12%). Australians lost 833,250 DALY due to premature death from cancer or living with cancer. Despite the high
survival and prevalence rates of cancer in Australia, this burden was almost entirely due to dying prematurely (94%), with only 6% of this burden due to living with cancer (Table 7.1).
Table 7.1: Burden of disease from all cancers combined, by sex, 2011
Males Females Person
Number % Number % Number %
Fatal burden (YLL) 442,228 94.1 340,121 93.7 782,349 93.9
Non-fatal burden (YLD) 27,882 5.9 23,019 6.3 50,901 6.1
Total burden (DALY) 470,110 100.0 363,140 100.0 833,250 100.0
Note: The ICD codes shown here describe the ABDS 2011 diseases generally. All cancers are coded using the ICD-10 as C00–C97, D45, D46, D47.1 and D47.3–D47.5; breast in situ are coded in the 10 as D05; and other benign, in situ and uncertain neoplasms are coded in the ICD-10 D00–D04, D06–D31, D34–D48.
Source: AIHW Burden of Disease Database.
7.2 Cancer type
In 2011, lung cancer (19%) was associated with the largest proportion of the cancer burden, followed by colorectal cancer (11%), breast cancer (8.5%), prostate cancer (5.9%) and
pancreatic cancer (5.3%). Together, these five cancers accounted for almost half the cancer burden (Table 7.2). Despite improved survival for all these cancers since 1982, the burden from these five cancers was predominantly due to dying early (Figure 7.1).
Table 7.2: Top 10 causes of fatal and non-fatal cancer burden, 2011
Fatal burden Non-fatal burden Total burden
Type % Type % Type %
Other benign, in situ and uncertain neoplasms (see
footnote 1) 4.4 Non-Hodgkin lymphoma
(C82–C86) 3.0 Unknown primary (see
footnote 1) 4.3
Melanoma of the skin
(C43) 4.0 Benign and uncertain brain
tumours (C70–C72) 2.8 Melanoma of the skin
(C43) 4.2
Leukaemia (C91–C95) 3.7 Leukaemia (C91–C95) 2.8 Leukaemia (C91–C95) 3.7
Liver (C22) 3.7 Other malignant neoplasms
(see footnote 2) 2.8
Other malignant neoplasms (see
footnote 2) 3.6
Notes
1. The ICD codes shown here describe the ABDS 2011 diseases generally. ICD codes were not necessarily the basis of the morbidity (non-fatal) estimates, as this depended on the data source used. Unknown primary is coded different for the analysis using the AIHW National Mortality Database, and is coded as C26, C39, C76–C79, C80, C97.
2. Other benign, in situ and uncertain neoplasms are coded as D00–D04, D06–D31, D34–D48. Other malignant neoplasms are coded as C17, C21, C26–C31, C37–C41, C46–C49, C51–C52, C57–C60, C63, C65–C66, C68–C69, C74–C75.
Source: AIHW Burden of Disease Database.
The burden of living with cancer compared with dying early varied by cancer type. Lung and pancreatic cancer had proportionately very little non-fatal burden due to the low survival rate of these cancers, whereas prostate cancer, melanoma of the skin and breast cancer (which had higher survival rates) had a proportionately higher non-fatal burden (Figure 7.1).
Notes
1. The ICD codes shown here describe the ABDS 2011 diseases generally. Cancers are coded in the ICD-10 as C00–C97, D45, D46, D47.1 and D47.3–D47.5.
2. CNS = Central nervous system, UPS = unknown primary site.
3. Data for this figure are in online Table A7.1.
Source: AIHW Burden of Disease Database.
Figure 7.1: Proportion of DALY due to fatal and non-fatal outcomes for selected cancers, 2011
Age
For people aged 25 and under, brain and central nervous system cancer and leukaemia accounted for a large proportion of the burden. For people aged between 25 and 50, breast cancer, melanoma of the skin, and colorectal cancer accounted for a large proportion of the burden. For people aged 55 and over, lung cancer, colorectal cancer, breast cancer and prostate cancer accounted for a large proportion of the burden (Figure 7.2).
All cancer Pancreatic Lung
Brain &CNS UPS Colorectal Melanoma Breast Prostate Cancer type
0 20 40 60 80 100
Per cent (%)
Non-fatal Fatal
Notes
1. The ICD codes shown here describe the ABDS 2011 diseases generally. Cancers are coded in the ICD-10 as C00–C97, D45, D46, D47.1 and D47.3–D47.5.
2. CNS = central nervous system, UPS = unknown primary site.
3. Data for this figure are in online Table A7.2 Source: AIHW Burden of Disease Database.
Figure 7.2: Cancer burden (DALY), by age and cancer type, 2011
0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+
Age group (years)
0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+
Age group (years)