Cancer control measures save 230,000 lives

New research showing more than 230,000 Australian lives have been saved by cancer control measures in recent decades highlights the pivotal role of GPs in cancer prevention and care.
 
The study, led by Cancer Council Victoria and published in the Australian and New Zealand Journal of Public Health, analysed age-standardised cancer mortality rates from 1950 to 2018.
 
It found almost a quarter of a million deaths have been avoided since overall cancer mortality rates peaked in the mid-1980s.
 
Some 65% of the avoided deaths occurred in the final 10 years of the study period (between 2009 to 2018), showing progress in the fight against cancer has accelerated and continued.
 
Authors pointed to ‘multifactorial’ reasons for the positive shift – a combination of societal changes, primary and secondary prevention strategies and better treatment options for those diagnosed.
 
Lead researcher and Deputy Head of Cancer Epidemiology at Cancer Council Victoria Associate Professor Brigid Lynch said the results show the real-world impacts of decades of Australian cancer control methods.

‘What we’re seeing is a snowball effect,’ she said.

‘Quit campaigns which have been running since the 1980s impacted smoking prevalence and led to a drop in lung cancer deaths. We’ve also seen the mortality rate drop markedly for breast, cervical and stomach cancer.

‘While we know more women are diagnosed with breast cancer today because of increased screening, thanks to early detection and improved treatment options, that mortality rate is falling.’ 
 
But not all cancers followed this trend, with mortality rates for liver and brain cancer continuing to rise.
 
Associate Professor Joel Rhee, who is Chair of RACGP Special Interests – Cancer and Palliative Care, said it is ‘heartening to witness the tangible positive impact of evidence-based prevention measures on cancer-related deaths in Australia’.
 
‘GPs are, and will increasingly be, central to cancer prevention efforts,’ Associate Professor Rhee told newsGP.
 
‘As our understanding of cancer deepens and technologies, such as genomics and AI, become more widespread, cancer screening and prevention are likely to become highly individualised.
 
‘GPs, with their generalist training and their continuing, trusting relationships with their patients, are uniquely positioned to assess individual risk and provide tailored advice for screening and prevention.’
 
Associate Professor Rhee added that these results also emphasise the ‘critical need for a long-term, strategic vision for cancer prevention’.
 
‘Many of these interventions are multi-faceted, require considerable time for widespread adoption, necessitate strong community and political backing, and it often takes years for their impact to be realised,’ he said.
 
Recent research published in The Lancet projected Australia would see a 51% increase in new cancer cases and a 36% increase in deaths between 2022 and 2044.
 
Experts say GPs need adequate support to face the challenge.
 
Chair of the RACGP Expert Committee – Quality Care, Professor Mark Morgan said the study’s results are positive but there is more work to be done.
 
‘This research shows age adjusted mortality rates from cancer across Australia have reduced by 11% for women, from a 1985 figure of 116.5 per 100,000. The reduction for men has been 20%, from a much higher baseline of 188.3 per 100,000,’ he told newsGP.
 
‘This is a good news story. It can be attributed to reduced smoking and other prevention, cancer screening programs and improved cancer survivorship.
 
‘There is more to be done. We know that engagement with cancer reduction strategies is not uniform for all populations and is well below ideal across the board.’
 
Professor Morgan said ‘GPs have a central role in reducing the impact of cancer’ and he points to the RACGP Red Book as being instrumental in pulling together evidence for screening and preventive healthcare activities across the life course.
 
He also believes GPs could be better supported to carry out their key role in cancer prevention and care.
 
‘GPs could be supported in their work to reduce the impact of cancer if health assessment item numbers could be billed for a wider range of ages,’ Professor Morgan said.
 
‘Imagine offering a comprehensive birthday check up to implement Red Book recommendations and to identify individual risk factors. Prevention would take front stage instead of being an opportunistic add on.
 
‘Using item numbers equivalent to the over 75 health assessment provides an opportunity to work with the wider GP practice team.’
 
Associate Professor Rhee agrees ‘ongoing and enhanced support is vital’.
 
‘GPs and general practice teams need to be kept abreast of the latest advancements in screening and prevention,’ he said.
 
‘New prevention and screening initiatives may require additional staffing or resources, and it is important that they are funded properly.
 
‘Investment in continuous professional development and resources will help empower primary care to meet these future challenges effectively.’
 
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