Australia leads global cancer survival rates – but more can be done

The study, recently published in The Lancet oncology, is part of the ongoing International Cancer Benchmarking Project, which aims to identify cancer survival variations between high-income countries and explore the underlying reasons for these variations to drive further improvement.
 
The seven countries for which data was analysed and compared were Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK. Researchers analysed data for cancers of the oesophagus, stomach, colon, rectum, pancreas, lung and ovary, using survival rates at one and five years after diagnosis.
 
Results showed overall increases in survival rates, reflecting positive developments in cancer treatment and diagnosis over time.
 
‘The study show[ed] consistent improvements … in all countries,’ Professor Sanchia Aranda, Chief Executive of Cancer Council Australia, said.
 
‘In Australia today, we now have an overall cancer survival rate of almost 70%, which has increased from 50% since 1990.’
 
Australia led the rest of the world in survival rates, with Australians the most likely to survive each cancer included in the study for at least one year after diagnosis.
 
And when examining five-year survival rates, Australia led the rates for cancers of the oesophagus (23.5%), stomach (32.8%), colon (70.8%), rectum (70.8%) and pancreas (14.6%), and came second to Canada in cancers of the lung and Norway for ovarian cancers.
 
But while these results are undeniably positive, Associate Professor Joel Rhee, Chair of the RACGP Cancer and Palliative Care Specific Interests network, was careful to observe the study does not necessarily provide a comprehensive perspective of overall cancer outcomes.
 
‘The five-year survival rate may not give us a complete picture. You need to look at the whole mortality rate from a particular disease in the human population, that’s probably a better indicator,’ he told newsGP.
 
‘Obviously, some of the figures are still not good. Five-year survival for oesophageal cancers are still terrible; almost three quarters of patients will die from oesophageal cancer after five years. Stomach and pancreatic cancers also look pretty horrid for the survival rate.
 
‘So there are things we could improve.’
 
One clear area of focus for improvement in Australia is the issue of access to timely diagnosis and treatment of cancers in particularly vulnerable populations, such as Aboriginal and Torres Strait Islander peoples, people living in rural and remote areas, and people from low socio-economic backgrounds.
 
‘We need to ensure that all of these people get a good deal, because we don’t want a situation where it’s just well-educated people living five kilometres from the CBD who get the best outcomes, then the rest of us don’t,’ Associate Professor Rhee said.
 
It is in this particular area that Associate Professor Rhee believes GPs have an especially important role to play.
 
‘GPs and general practices ensure equity, and I think that’s really critical,’ he said.
 
‘We need to keep fighting and speaking up for our patients and try to do our best to ensure that all of our patients get good outcomes. And I think most of us are doing a pretty good job, but it’s that reminder that we need to keep doing it.’
 
Professor David Currow, Chief Cancer Officer of NSW and Chief Executive Officer of the Cancer Institute NSW, and an author on the paper, discussed further key issues for continued improvements in cancer survival, including timeliness and multidisciplinary care.
 
‘We know that people being seen at the right place and at the right time increases their chance of being offered life-saving treatment and their chance of long-term survival,’ he said.
 
‘This means increasing the numbers of people who are having their cancer detected earlier, ensuring that they are referred to a multidisciplinary cancer care team, and ensuring that if surgery is appropriate, they receive it in a hospital performing the procedure regularly.’
 
Associate Professor Rhee agrees, highlighting the GP’s role in facilitating these processes.
 
‘In terms of general practice, it comes down to ensuring that when patients do present with symptoms that may be a cancer, they are investigated appropriately and then referred to the appropriate cancer services with minimal delays,’ he said.
 
‘And making use of multidisciplinary services and ensuring that we continue to work closely with them, I think that’s a key part of ensuring best outcomes for our patients.’

Cancer Cancer survival Medical research Oncology Population health