Cancer incidence

Introduction

Cancer incidence is the number or rate of new cases of cancer diagnosed in a population during a given time period, defined as a calendar year in this section.

In 2020, there were 32,547 new cancer cases reported in Queensland equal to a standardised incidence rate (ASR or standardised rate) of 532.8 diagnoses per 100,000 persons (Figure 1).

The number of new cancer cases for the selected cancers in this report were 3,006 (lung), 3,113 (bowel), 3,790 (breast), 801 (pancreatic), 4,902 (prostate), 4,189 (melanoma of the skin), and 262 (cervical) (Figure 1).¹

Demographic differences

Cancer incidence rates increased markedly in older age groups (Figure 1) and this was more pronounced in males than females. In 2020, incidence rates for all cancers for those 80 years and older were 1.6 times higher in males than females (3,732.0 per 100,000 for males and 2,329.1 per 100,000 for females, Figure 1).¹

The highest cancer incidence rates were predominantly in males 80 years and older, with rates varying by cancer type:

• lung cancer: 443.6 per 100,000 males 80 years and older compared to 237.6 per 100,000 in females 80 years and older. Rates were similar in males and females in younger age groups.
• melanoma of the skin: 481.9 per 100,000 in males 80 years and older compared to 198.1 per 100,000 in females 80 years and older.

Cervical cancer incidence rates were highest in 40 to 59 year olds (17.7 per 100,000 females)—the remaining younger and older age groups were similar at about 10 per 100,000 females.

Prostate cancer incidence rates were highest in 60 to 79 year olds (802.0 per 100,000 males)—6.9 times higher than in 40 to 59 year olds (115.8 per 100,000 males).

Remoteness and socioeconomic differences

Two measures that classify Queensland’s diversity are remoteness,² and the area-based index of relative socioeconomic advantage and disadvantage.³

Remoteness

For all cancers, there was little regional variation in standardised incidence rates for persons and by age groups (Figure 2).¹ Standardised incidence rates varied by remoteness for some individual cancers, for example:

• breast cancer was 53.0% higher in major cities than in remote and very remote areas (67.0 and 43.8 per 100,000 persons, respectively)
• lung cancer was 36.6% higher in remote and very remote areas than in major cities (62.0 and 45.4 per 100,000 persons, respectively).

Socioeconomic status

For all cancers, there was little variation by socioeconomic areas in standardised incidence rates for persons, however, for older age groups, considerable differences were evident (Figure 2).¹

Variability in standardised incidence rates between socioeconomic areas was evident for some individual cancers, for example:

• colorectal cancer incidence was 38.1% higher in the most disadvantaged areas compared to advantaged areas (59.4 and 43.0 per 100,000 persons, respectively)
• lung cancer incidence was 90.2% higher in the most disadvantaged areas than in the most advantaged areas (61.8 and 32.5 per 100,000 persons, respectively).

Cancer incidence trends

National comparisons

Queensland cancer incidence rates have been higher than Australian rates for three decades (Figure 3). In 2018, the standardised incidence rate for all cancers was 10% higher in Queensland (542.0 per 100,000 persons in Queensland compared to 493.9 per 100,000 for Australia).

The main driver of this difference is higher melanoma rates in Queensland. Melanoma of the skin is strongly associated with ultraviolet (UV) light. The Queensland UV index is 3 or above year round, which is high enough to cause skin damage after only 10 minutes of exposure.

Incidence trends over time were broadly similar between Australia and Queensland. For all cancers, standardised incidence rates for persons generally increased from 1982 to approximately 2008, then stabilised (Figure 3). Trends for specific cancers showed:

• prostate cancer, melanoma of the skin and breast cancer generally increased from 1982 to 2018
• colorectal cancer incidence peaked in the early 2000s then decreased
• lung cancer incidence was stable from 1982 to 2018.

Nationally, standardised incidence rates of pancreatic cancer have been increasing since 2002. National rates increased from 9.6 per 100,000 persons in 2002 to 12.5 per 100,000 persons in 2018.⁴

Demographic differences

Some individual cancers showed age or sex related incidence differences (Figure 4).

Colorectal cancer: the incidence was higher in males, but trends were similar for males and females. The main driver of the decrease in overall incidence was the decline in 60 to 79 year olds, with rates stable in 40 to 59 year olds and variable in those 80 years and older.

Lung cancer: incidence trends varied considerably by age and sex with:

• for females 60 years and over, incidence has been increasing for three decades
• for males, the incidence in the 40 to 59 and 60 to 79 age groups has been decreasing while for males 80 years and older incidence was stable but highly variable
• in 1982, the Queensland lung cancer rate in 60 to 79 year olds was 6.0 times higher in males than female but reduced to 1.3 times higher in 2020.

This clear difference for lung cancer reflects sex differences in smoking uptake and cessation. Smoking prevalence peaked in males in 1945 or before, but for females, it peaked in the mid-1970s.⁵

Melanoma of the skin: incidence has been increasing in all age groups 40 years and over, and was higher in males than females, especially in those 60 years and older.
In 2020, the Queensland incidence rate in:

• males 80 years or older was 2.4 times higher than Queensland females of the same age (481.9 compared to 198.1 per 100,000, respectively)
• males 60 to 79 years was 1.7 times higher than Queensland females of the same age (282.2 compared to 163.3 per 100,000, respectively).

Queensland incidence rates for melanoma of the skin were consistently higher than Australian incidence rates across age groups.

Nationally, lifetime risk of a melanoma of the skin diagnosis and by age 30 and 60 was estimated to be:⁴

• By age 30: from 1982 to 1997, risk increased from 1-in-600 to 1-in-430. From 1997 to 2020, the risk decreased by half to an estimated 1-in-1,170 people in 2020.
• By age 60: risk increased from 1982 and peaked in 2005 at 1-in-56. Risk stabilised from 2012 and was estimated to be 1-in-65 in 2020.
• Lifetime: from 1982 to 2020, risk increased from 1 in 46 persons to an estimated 1-in-15 persons. Increases in males (1-in-47 males in 1982 to 1-in-12 males in 2020) were higher than females (1-in-45 females in 1982 to 1-in-18 females in 2020).

Increasing lifetime risk of melanoma diagnosis is driven in large part by increases in life expectancy and the much higher incidence rates in older age-groups.

Additional information

Data and statistics

Visit Cancer Alliance Queensland (CAQ) to:

• learn more about accessing cancer statistics
• explore the CAQ data dashboards

Supplemental Figure S1 presents the same results as Figure 1 but better highlights relative differences. It also includes melanoma of the skin by age and sex in a format to better view younger age groups.

Information and strategies

Visit Queensland Cancer screening for more information about cancer screening services.

Section technical notes

• Where presented, ratios were calculated using higher precision estimates than in text. Ratios calculated using estimates in text may differ.
• Prostate and cervical cancers occur only in males and females respectively. Where rates are provided for “persons” for these cancers it is done for comparative purposes.
• 5-year cancer survival was calculated using the Observed method of survival calculation for both Queensland and Australia.
• Comparisons are made of incidence rates for Queensland obtained from the Queensland Cancer Register⁶ and for Australia obtained from the Australian Institute of Health and Welfare.⁷ It is acknowledged that there will be minor differences in case numbers due to data collection methods. The maximum error between sources in most recent years was estimated to be +/- 1-2% (for rates).

References

1. Queensland Health. 2023. Queensland Cancer Register: Cancer Alliance Queensland. Accessed: 1 November 2022.
2. Hugo Centre for Migration and Population Research. 2018. Accessibility/Remoteness Index of Australia (ARIA). Accessibility/Remoteness Index of Australia (ARIA). Accessed: 1 October 2022.
3. Australian Bureau of Statistics. 2018. Socio-Economic Indexes for Areas (SEIFA) 2016. 2033.0.55.001 - Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2016. Accessed: 1 October 2022.
4. Australian Institute of Health and Welfare. 2022. Risk of Melanoma of the Skin by Age and over Time. Accessed: 13 February 2022.
5. Tobacco in Australia. 2021. Prevalence of Smoking-Adults.
6. Queensland Health. 2023. Queensland Cancer Register: Cancer Alliance Queensland. Accessed: 1 November 2022.
7. Cancer Australia. 2022. Cancer in Australia Statistics.