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.
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Developments in the Health Sector and Cancer
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
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
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
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
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
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
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
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