This document discusses developments in the health sector and cancer in Australia. It notes that Australia ranks highly among OECD countries for health expenditure per capita and health outcomes. Cancer mortality rates have declined significantly for several types of cancer due to public health measures like tobacco control, screening programs, and improved treatments. However, obesity rates are rising and greater efforts are needed to address risk factors like physical inactivity, diet, and alcohol to further reduce the cancer burden.

1. DEVELOPMENTS in the HEALTH
SECTOR and CANCER
MOGA/PCPA Joint Scientific Meeting
Sydney - 13 August 2010
Professor Jim Bishop AO
Chief Medical Officer
Australian Government Department of Health and Ageing

2. Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)
7538
5004
4627
4210
4079 4063
3970
3793 3737 3696 3677
3540 3470
3359 3353
3129 3060 3008
2902 2870
2729 2687 2683
2151
1801 1781 1737
1437
1213
999
852 767
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
1. Refers to insured population rather than resident population. 2. Current expenditure. 3. 2006. 4. 2007. Source: OECD, OECD Health Data, June 2010
Public expenditure on health Private expenditure on health
OECD HEALTH DATA 2010
How Does AUSTRALIA Compare

3. AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010

4. SELF-ASSESSED PHYSICAL &
MENTAL HEALTH, 2007
Source: AIHW Australia’s Health 2010

5. BROAD CAUSE MORTALITY
TRENDS AUSTRALIA
Source: AIHW

6. All Cancer- Mortality/Incidence
ratios for selected countries - 2008
Source: IARC 2010.
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Kenya
Nigeria
EgyptVietNam
Turkey
India
China
Russia
South
Africa
G
reece
Brazil
Japan
Czech
Republic
Italy
United
Kingdom
CanadaG
erm
anySweden
New
Zealand
USAAustralia
Mortality-to-incidenceratio
Males
Females

7. Changes in Deaths rates in Males
using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW

8. Changes in Deaths Rates in
Females Using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW

9. BREAST CANCER
MORTALITY
NEJM 2005
Source: NEJM 2005

10. Cancers with reducing death
rates 1997 to 2006 – all ages
Lung, -18.5
Colon, -19.6 Prostate, -19.7
Leukaemia, -23.7
Stomach, -29.4
Head and Neck, -23.7
Bladder, -18.5
Testicular, -42.2
Breast, -13.8
Cervix, -38.3
NHL, -25.1
Unknown, -24.8
Rectum
, -19.9
Bowel
, -19.7
All cancers, -13.8
, -24.3
-18.5
Kidney
, -24.1
, -15.2
-31.9
, -21.1
-19.0
-19.0
, -18.9
-7.9
-45
-40
-35
-30
-25
-20
-15
-10
-5
0
Male Female
Source: Tracey et al, Cancer Institute NSW

11. FIVE YEAR SURVIVAL
RATES - 2004
NSW SEER
Non small cell lung 13% 14%
Colon 65% 67%
Rectum 66% 69%
Breast Cancer 89% 90%
Lymphoma (DL) 53% 53%
Source: Tracey et al – Cancer Institute NSW

12. Projected YLLs – Three scenarios,
Australia – 1980 to 2016
Source: Bishop et al – Cancer Institute NSW

13. PROJECTED BURDEN of
MAJOR DISEASE GROUPS, 2010
Source: AIHW Australia’s Health 2010

14. THE KEYS TO
PREVENTION
0.0 2.0 4.0 6.0 8.0
Tobacco
Blood pressure
Overweight/obesity
Physical inactivity
Blood cholesterol
Alcohol
Fruit/vegetables
Illicit drugs
Air pollution
Unsafe sex
% DALYs
Total of 32%
Source: Table 4.1 AIHW Australia’s Health 2008

15. AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010

16. SMOKING IN
AUSTRALIA
SMOKING
STATUS
NSW VIC QLD WA SA TAS ACT NT AUS
Daily 16.4 16.5 17.2 14.8 16.5 22.7 14.7 25.3 16.6
Weekly 1.2 1.5 1.4 1.2 1.5 0.6 0.9 1.2 1.3
Less than
Weekly
1.4 1.7 1.3 1.4 1.8 1.6 1.6 1.3 1.5
Ex-smoker 24.7 24.4 25.7 28.3 24.1 26.5 24.8 22.4 25.1
Never
smoked
56.3 55.9 54.5 54.3 56.2 48.6 57.9 49.8 55.4
National Drug Strategy Household Survey 2007Source: 2007 Household Survey, Australian Government

17. AUSTRALIA’S RECORD IN
TOBACCO CONTROL
 Advertising Bans
 Under the counter at retail sites
 Banning smoking in restaurants, pubs and cars
 Graphic warnings on cigarette packets
 Anti-tobacco campaigns
 Increase in tobacco excise
 Plain packaging

18. OBESTITY INCREASING
FOR ALL
Source: AIHW: Australia’s Health 2008

19. Increased Risk Body Fatness Oesophagus
Pancreas
Colorectal
Breast (PM)
Endometrum
Abnormal Fatness Colorectal
Reduced Risk Physical exercise Colon
SOURCE: World Cancer Research Fund: Food, nutrition, physical activity and prevention of cancer, 2007
OBESITY and CANCER

20. Total Cancer Cases and Deaths
per year (1972 to 2036)
Source: Cancer Institute NSW

21. NSW Cancer Deaths, Major
Cancer Types (2007-2036)
Source: Cancer Institute NSW

22. Milestones in
Cancer Control
 Public health measures in smoking reduction ,
screening breast, cervix, bowel, health literacy
 Adjuvant treatment of breast, lung and bowel
cancer
 New anti-cancer drugs and symptom control
drugs
 Cancer research changing practice
 Cancer registries, data linkage and analysis

23. PRIORITY HEALTH AREAS
SOURCE: NHMRC Research funding 2010 facts book
PRIORITY HEALTH AREAS

24. HEALTH REFORM
PROPOSED STRUCTURES
 National Health Performance Agency
 National Pricing Authority
 Expanded Australian Commission of
Safety and Quality in Health Care
(ACSQHC)
 Preventative Health Agency

25. CURRENT INITIATIVES
in
CANCER CONTROL
 Australian health Survey
 Tobacco Control initiatives
 Cancer funding $2 billion 09/10

26.  Four components run by ABS 2011- 2013
- Health Survey
- ATSI Health Survey
- Nutrition and Physical Activity
Survey
- Health measurement Survey
 Around 50,000 participants
 De-identified data available as summary
statistics, tables
AUSTRALIAN HEALTH
SURVEY

27.  Integrated Cancer Centre ($526m) – Camperdown
and Parkville
 Regional Cancer Centres ($560m) – 20 sites
announced
 Digitalization of breast screening services
 Access to new anti-cancer drugs ($613m)
 Amalgamation Cancer Australia and NBOCC
Programs
CURRENT INITIATIVES
IN CANCER CONTROL

28. CLINICAL GUIDELINES
Supports for Clinical Decision Making
 Evidence Base
 Highest Impact
 Range of best practice tools
 Successful implementation methods
 Monitor and report

29. CLINICAL GUIDELINES
Highest Impact
 Greatest burden of disease
 Greatest harm from poor practice
 Greatest demonstrated need:
- New Standard of Care
- Proven variation in practice
 Greatest time spent/cost to health system

30.  Cancer Control in Australia is successful by
international measures with more needed
 Research breakthroughs have delivered
population mortality reductions in Cancer
 New research is needed in successful
interventions for obesity, physical activity,
diet and alcohol
 Better methods of identifying susceptibility,
early cancer and evidence-based interventions
are urgently needed
CONCLUSIONS