Cancer now our number one killer, but only because survival rates for other diseases have improved

Cancer has surpassed heart disease as Australia’s biggest killer – but it’s actually good news.

The unwanted title says more about efforts to overcome other conditions, and our extending lifespan, than it does about the big C.

And Adelaide’s leading cancer researchers at the South Australian Health and Medical Research Institute are confident breakthroughs are on the way. Inside the North Tce institution, scientists are working towards better treatments and therapies for forms of the disease ranging from prostate cancer to leukaemia.

Since SAHMRI opened its doors in 2013, researchers have been collaborating across disciplines like never before, cancer research director Professor Deborah White said.

“In my previous jobs, I’ve never spoken to a cardiologist for reasons of my work, but now we do that – it’s very collaborative,” Prof White said.

“There are some cancers we have a very good handle on, like chronic myeloid leukaemia and, to some extent, acute lymphoblastic leukaemia and other tumours.”

However, she said there remained many others, including pancreatic cancers, with five-year survival rates as low as 6 per cent. “We’ve got a long way to go in those sorts of tumours to understand them,” Prof White said.

Modern medicine and improved lifestyles have extended the lifespan of Australians by 33 years since 1890, with a boy born today is expected to live to the age of 80.4 and a girl to 84.5.

While mortality rates for cancer have ­improved slightly in the past few years, the Australian Institute of Health and Welfare’s Michelle Gourley said gains made in other areas had been more significant.

“The biggest change has been the decline in death rates due to circulatory diseases, and that is largely ­reflected in a decline in all-cause mortality,” she said.

“Cancer mortality rates are slightly higher than circulatory diseases when we group them, having overtaken them as the leading disease group causing death in Australia in recent years.

“But, when you look at the specific causes of death in the disease groups, coronary heart disease is still the leading cause. Second is Alzheimer’s and dementia, then cerebrovascular diseases, and lung cancer is fourth.”

There are many simple lifestyle factors that reduce the risk of cancer.

Cancer Council SA chief executive officer Lincoln Size said quitting smoking, limiting alcohol, being sun smart and exercise were all important.

“At least one-in-three cancers are preventable by choosing a healthy lifestyle and participating in relevant cancer screening programs,” he said.

“More than 13,000 cancer deaths each year in Australia are due to smoking, sun exposure, poor diet, alcohol, inadequate exercise or being overweight.”

Mr Size said cancer rates were high because the disease was more prevalent as the population aged. “(But) while the number of new cancer cases increases each year, more people are surviving having cancer,” he said.

A century ago, infectious diseases were by far Australia’s biggest killer, before improved hygiene and better nutrition saw the mortality rate drop by a quarter in a single year, and by 94 per cent at the last count.

Circulatory or cardiovascular disease – the general terms given to conditions affecting the heart or blood vessels – have been the biggest underlying cause of death for the past 99 years, but their toll has been cut by more than 60 per cent since a mid-century epidemic of the 1960s.

At the same time, the total number of Australians dying from all forms of cancer rose slowly for 90 years before plateauing in the past decade.

The AIHW’s comprehensive mortality report showed the two leading killers were neck and neck in 2014, with circulatory disease claiming 192 lives per 100,000 Australians, and cancer 191. The longer lifespan of Australians has seen dementia and Alzheimer’s disease grow to ­become the nation’s second-biggest killer, when the various forms of cancer are considered separately.

But, while the conditions barely rated a mention as a leading cause of death decades ago, actual rates were probably much higher than ­reported because doctors did not ­routinely record them as a cause of death.

Heart Foundation SA chief executive officer Imelda Lynch warned the ageing population, as well as risk factors including high blood cholesterol, high blood pressure and being physically inactive and overweight, could drive up heart disease and stroke death rates in future.

While cancer mortality rates are slightly higher than for cardiovascular disease, the single leading cause of death across the disease groups was ischaemic heart disease – also known as coronary artery disease and including angina, myocardial infarction and sudden cardiac death – with 19,777 deaths in 2015.

“Ischaemic heart disease has remained Australia’s leading cause of death over the past decade,” Ms Lynch said.

“Both cancer and heart disease have common risk factors including smoking, poor nutrition, overweight and obesity and physical inactivity.”

Ms Lynch said a “co-ordinated approach” was needed to manage these risk factors.

“We would help save the lives of thousands of people whose lives are lost prematurely,” she said.

“We know the advancements in early detection, better care, improved technologies, tobacco control – as well as public education campaigns such as the Heart Foundation’s “warning signs of heart attack” – have contributed to the drop in the numbers of deaths.

“To help reduce your chances of developing cancer or heart disease, the Heart Foundation suggests we all need to stop smoking, sit less and move more and eat a variety of healthy food.”

LEADING CAUSES OF DEATH BY AGE GROUP

UNDER 1

• Perinatal/congenital
• Ill-defined
• SIDS
• Accidental threats to breathing
• Metabolic disorders

1-14

• Land transport accidents
• Perinatal/congenital
• Brain cancer
• Drowning
• Cerebral palsy and related

15-24

• Suicide
• Land transport accidents
• Accidental poisoning
• Assault
• Event of undetermined intent

25-44

• Suicide
• Accidental poisoning
• Land transport accidents
• Coronary heart disease
• Liver disease

45-64

• Coronary heart disease
• Lung cancer
• Breast cancer
• Suicide
• Colorectal cancer

65-74

• Lung cancer
• Coronary heart disease
• Chronic obstructive pulmonary disease (COPD — long-term lung disease including emphysema, chronic bronchitis and chronic asthma)
• Cerebrovascular disease (most commonly stroke)
• Colorectal cancer

75-84

• Coronary heart disease
• Cerebrovascular disease
• Dementia and Alzheimer’s
• Lung cancer
• COPD

85-94

• Coronary heart disease
• Dementia and Alzheimer’s
• Cerebrovascular disease
• COPD
• Heart failure

LEADING CAUSES OF DEATH

MEN / WOMEN

1. Coronary heart disease 11,082 / 9091
2. Dementia and Alzheimer’s 4106 / 7859
3. Cerebrovascular disease 4279 / 6486
4. Lung cancer 4947 / 3304
5. Chronic obstructive pulmonary disease 3911 / 3114

WAYS TO AVOID AUSTRALIA’S BIGGEST KILLERS

CARDIOVASCULAR DISEASE

1. See your doctor for a heart and stroke check
2. Be smoke-free
3. Get your blood pressure checked, manage your blood cholesterol and diabetes
4. Be physically active and achieve and maintain a healthy weight
5. Eat a variety of healthy foods but have less salt and limit alcohol

Source: Heart Foundation

CANCER

1. Get checked with screening tests
2. Eat well and be active, as one in three cancer deaths is the result of unhealthy lifestyle
3. Quit smoking, which causes 16 different cancers and one in eight cancer deaths
4. Be SunSmart

Source: Cancer Council

DEMENTIA AND ALZHEIMER’S

1. Look after your heart and be physically active
2. Mentally challenge your brain
3. Follow a healthy diet
4. Enjoy social activity

Source: Alzheimer’s Australia

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