Australia's high cancer survival rates attributed to earlier detection
Australia has better cancer survival rates than other similar high-income countries, a global study has found.
The study, published in the Lancet Oncology journal by the International Cancer Benchmarking Partnership, reviewed 3.9m cancer cases from Australia, New Zealand, the UK, Norway, Ireland, Canada and Denmark and compared the one-year and five-year survival rates for seven types of cancer: bowel, oesophageal, pancreatic, stomach, rectum, lung and ovarian.
Australia had the highest five-year survival rate in all but lung and ovarian cancer. The five-year survival rate in Australia for oesophageal cancer was 23.5%, stomach cancer 32.8%, colon cancer 70.8%, rectal cancer 70.8% and pancreatic 14.6%.
All countries showed an improvement in one- and five-year survival rates over the data period, which extended from 1995 to 2015.
The UK had the lowest five-year survival rate of five of the seven cancers, the exceptions being oesophageal (lowest in Denmark) and ovarian (lowest in Ireland).
The chief executive of Cancer Council Australia, Prof Sanchia Aranda, said the higher survival rates could be attributed to earlier detection, which she said was due to the management of referral and screening services in Australia.
Australia had the densest per capita availability of imaging services for the seven cancers represented in the study, Aranda said.
“In Australia our primary care practitioners can refer patients for a full range of investigation, whereas in places like the UK that’s mediated through a secondary referral to a specialist,” she told Guardian Australia. “So we can get it done much earlier, and either rule out cancer or make a directed referral.”
Australia’s split public and private health system also allows a doctor to refer a public patient to a private diagnostic service, with part of the cost of that service covered by Medicare.
Aranda said that model took the burden off the public system and “evens out outcomes” but there was still a sharp divide in survival rates between wealthy people and those from lower socioeconomic groups.
“People in the lowest socioeconomic group have a 37% higher mortality from cancer than people in
the highest economic group,” she said. “So we shouldn’t be complacent about being number one. It should spur us on to make sure that those outcomes are equitable across their population.”
People from lower socioeconomic groups had a lower rate of participation in national screening programs for breast, bowel and cervical cancer, Aranda said.
Poorer people are 40% more likely to be diagnosed with cervical cancer, and 2.5 times more likely to die from it. Among Indigenous communities, rates of mortality are 3.8 times higher.
Only four in 10 eligible Australians (those aged 50 to 74) take part in the national bowel screening program. A 50% increase in participation would save an additional 84,000 lives through early diagnosis by 2040, Aranda said.
The director of cancer medicine at the Peter MacCallum Cancer Centre in Melbourne, Prof Danny Rischin, said the study showed the Australian system was working relatively well to provide high quality care. But he urged caution in interpreting the data, because of classification differences between jurisdictions.
“I think the important trend is that overall, looking at the seven countries and across the different cancers, we’re right up the top for all of them and if we’re not first we’re second,” he said. “So I think overall the results suggest that our system is working relatively well.”