Cancer in New Zealand: Trends and Projections

Cancer in New Zealand: Trends and Projections

Date of publication: November 2002

Cancer is a major public health issue in New Zealand, as in other economically developed countries.

It ranks second as a cause of death (after cardiovascular disease), accounting for more than a quarter of all deaths in the late 1990s.

Furthermore, the burden of cancer – especially tobacco related cancer – falls disproportionately on Maori and on socioeconomically disadvantaged individuals, families and communities, so contributing to health inequality. Most importantly, the causes of many cancers are understood and significant proportions are preventable or amenable to early detection and cure through screening.

These facts led to the inclusion of cancer as a priority objective in the New Zealand Health Strategy, launched by the Minister of Health on 14 December 2000. Since then, the Ministry of Health has been working in partnership with the New Zealand Cancer Control Trust to develop a national cancer control strategy.

Cancer in New Zealand: Trends and projections summarises statistical models of cancer incidence and mortality produced by the Public Health Intelligence group within the Ministry of Health.

Models have been produced for all adult cancer, all childhood cancer, and some 26 selected types of cancer separately. The models were fitted to historical trend data from the 1950s (incidence) or 1970s (mortality) to the late 1990s, and then projected out to the early 2010s.

The models provide a valuable input to the development, implementation and evaluation of the New Zealand Cancer Control Strategy.

The projections of cancer risk and burden contribute to estimates of need on which investment decisions can be based, including plans for health promotion campaigns, workforce development, purchase of capital items, and organisation of service delivery.

This needs assessment is intended primarily to assist the policy analysts and cancer experts involved with the different phases of the New Zealand Cancer Control Strategy at the national level. However, the projections may also be of interest to District Health Board planners, as well as to a wider audience of cancer professionals, public health workers, academic researchers and community groups.

Document availability

This publication is not available in hard copy. It is available on this website as a series of PDF files below. The annex to the report, which provides full results for each type of cancer, is available only on this website as a set of Excel spreadsheets.

Cancer in New Zealand: Trends and Projections

Foreword and Contents
Cancer is a major public health issue in New Zealand, as in other economically developed countries. It ranks second as a cause of death (after cardiovascular disease), accounting for more than a quarter of all deaths in the late 1990s.

(PDF, 58 kB)

Part I

Chapter 1: Introduction
The objective of this report is to model and project cancer incidence and mortality counts and rates, for selected cancers and all cancers combined, for males and females, from the early 1950s (for incidence) and the early 1970s (for mortality) to the early 2010s.

(PDF, 34 kB)

Chapter 2: Guide for readers
The full report is divided into two parts plus an annex of detailed tables of results. The hardcopy version of the report contains only the two parts. The annex, which is not included in the hardcopy version of the report, provides spreadsheet tables of the full set of results (ie, final model output of incidence and mortality, both rates and counts, plus credible intervals) by five-year age group and five-year period. Samples of the tables – those for all adult cancer and for childhood cancer – are included in the relevant Part II chapters.

(PDF, 105 kB)

Chapter 3: Data and methods
The principal source of data on cancer registrations is the New Zealand Cancer Registry (NZCR), which is administered as part of the National Minimum Data Set (NMDS) by the New Zealand Health Information Service (NZHIS).

(PDF, 98 kB)

chapter 4: Summary of results
This chapter summarises the key results of the modelling and forecasting process.

(PDF, 387 kB)

Chapter 5: Distribution of the cancer burden
This chapter provides a different perspective on the results presented in other chapters, namely an analysis of age and gender differences in the distribution of the cancer burden, both in the mid to late 1990s and (projected) the early 2010s.

(PDF, 421 kB)

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Chapter 6: Conclusions
Statistical forecasts of incidence and mortality rates and counts for 28 cancer sites (including 'all adult cancer') have been produced for a 15 year forecasting period, 1996/97 to 2011/12.

(PDF, 38 kB)

Part II

Chapter 7: All adult cancer
Cancer is a heterogeneous group of conditions with multiple independent and interacting causes. Nevertheless, it is useful to analyse and forecast the burden of cancer as a whole.

(PDF, 377 kB)

Chapter 8: Childhood cancer
Cancer in children (0–14 years) is relatively uncommon, accounting for less than 1% of cancer registrations and cancer deaths when all ages are included.

(PDF, 162 kB)

Chapter 9: Bladder cancer
The major causes of bladder cancer are thought to be tobacco smoking and occupational chemical exposure in the rubber, organic dye, metal refining, petrochemical and paint industries (Department of Health 2000).

(PDF, 311 kB)

Chapter 10: Bone and connective tissue cancer
Cancer of bone and connective tissue is relatively uncommon, representing less than 1% of all cancers among adults.

(PDF, 311 kB)

Chapter 11: Brain cancer
Tumours of the brain are among the most morphologically and clinically heterogeneous of cancers at any site.

(PDF, 324 kB)

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Chapter 12: Breast cancer
This chapter is restricted to breast cancer among females (the very small number of cases among males is included in the analysis of 'Adult cancer of other sites').

(PDF, 182 kB)

Chapter 13: Cervical cancer
Cervical cancer comprises two distinct sub-types – squamous and adenocarcinoma.

(PDF, 193 kB)

Chapter 14: Colorectal cancer
Colorectal cancer is currently the most common cancer among males in terms of incidence, and second most common (after lung cancer) in terms of mortality.

(PDF, 309 kB)

Chapter 15: Endometrial cancer
Endometrial cancer currently (late 1990s) ranks sixth among the selected sites for incidence and twelfth for mortality, among females.

(PDF, 182 kB)

Chapter 16: Gallbladder cancer
When measured by number and annual registrations, gallbladder cancer is the least common among the selected sites for males and the fourth least common among females.

(PDF, 298 kB)

Chapter 17: Hodgkin's disease
Hodgkin's disease is a rare form of cancer. In 1996/97 it represented 0.4% of all cancer registrations and 0.2% of all cancer deaths, corresponding to 35 and 25 registrations and nine and seven deaths in males and females, respectively.

(PDF, 323 kB)

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Chapter 18: Kidney cancer
Cancers of the kidney currently represent 2% of all cancer cases. Tobacco smoking, and possibly obesity, are recognised risk factors (Aitchison 2001b).

(PDF, 319 kB)

Chapter 19: Laryngeal cancer
Cancer of the larynx is relatively rare, and is often analysed within the group of head and neck cancers (in this report, head and neck cancers are separated into cancer of the larynx and cancer of the lip, mouth and pharynx for modelling purposes).

(PDF, 311 kB)

Chapter 20: Leukaemia
Leukaemia in adults is a diverse group of malignancies, accounting for 3% of all cancer incidence and mortality.

(PDF, 312 kB)

Chapter 21: Lip, mouth and pharynx cancer
Lip, mouth and pharynx (LMP) cancers are a heterogenous group of upper aerodigestive tract cancers, for which exposure to tobacco smoke, and to a lesser extent, alcohol appear to be major risk factors; human papilloma virus infection may also play a role (Forastiere et al 2001).

(PDF, 314 kB)

Chapter 22: Liver cancer
Primary liver cancer is relatively uncommon, representing less than 1% of all registrations and less the 2% of all cancer deaths.

(PDF, 307 kB)

Chapter 23: Lung cancer
Among the selected cancer sites lung cancer currently ranks third for males and fourth for females in terms of incidence.

(PDF, 305 kB)

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Chapter 24: Melanoma
Until the Cancer Registry Act 1993 came into force, melanoma cases were seriously under-registered (unlike other cancers, most melanoma cases are not admitted to hospital, removing this source of notification).

(PDF, 320 kB)

Chapter 25: Myeloma
Myeloma is a relatively rare form of cancer, accounting for less than 2% of the cancer burden.

(PDF, 305 kB)

Chapter 26: Non-Hodgkin's lymphoma
Non-Hodgkin's lymphoma (NHL) is a heterogeneous category, comprising lymphomas of all histological types and anatomical sites other than Hodgkin's disease.

(PDF, 314 kB)

Chapter 27: Oesophageal cancer
Cancer of the oesophagus comprises two distinct sub-tpes with different aetiologies: squamous carcinoma of the upper and middle third, related to tobacco and alcohol exposure; and adenocarcinoma of the lower third, related to gastro-oesophageal reflux disease (GORD, or Barrett's oesophagus) and thus to the emerging obesity epidemic (Spechler 2002).

(PDF, 317 kB)

Chapter 28: Ovarian cancer
Ovarian cancer is currently (late 1990s) ranked fifth for incidence and fourth for mortality among all cancer sites for females.

(PDF, 184 kB)

Chapter 29: Pancreatic cancer
Cancer of the pancreas currently ranks 11th among males and 10th among females for incidence, but is the sixth most common cause of cancer deaths among males and the fifth among females.

(PDF, 310 kB)

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Chapter 30: Prostate cancer
Prostate cancer is currently the second most common cancer in terms of incidence and the third most common in terms of mortality among males.

(PDF, 181 kB)

Chapter 31: Stomach cancer
Stomach cancer comprises two distinct sub-types: cancer of the body of the stomach, related to Helicobacter pylori infection and the use of salt as a food preservative; and cancer of the oesophago-gastric (OG) junction, related to gastro-oesophageal reflux disease (GORD), and so to obesity (Devesa et al 1998).

(PDF, 304 kB)

Chapter 32: Testicular cancer
Testicular cancer accounts for 1.7% of all registrations, but less than 0.2% of all cancer deaths, reflecting its low case fatality compared to other types of cancer.

(PDF, 193 kB)

Chapter 33: Thyroid cancer
Thyroid cancer is relatively uncommon, particularly among males.

(PDF, 306 kB)

Chapter 34: Adult cancer of other sites
Adult cancer of all sites other than those selected for individual projection have been grouped together as 'adult cancer of other sites'.

(PDF, 306 kB)

References

(PDF, 48 kB)

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Annex to report

(XLS, 448 kB)