How bad is bad – rating cancers

How bad is bad – rating cancers

Around 125,000 Australians will be diagnosed with cancer sometime this year. That’s just over 5 new cases per 1,000 Australians. Chances are, someone I know knows some one being diagnosed this year, and they’ll tell me about it. Cancer is never good news. But they’re also not all the same. While some are hard to beat, others have very decent survival rates.

So how bad is my mate’s mate’s cancer?

(This post focuses purely on the likelihood of death as a measure of ‘badness’.)

 

Some are deadlier than others

One method of comparing a condition’s “deadliness” is the mortality-to-incidence ratio (MIR). The MIR denotes the number of people who die of a particular cancer in a given year, to the number of people diagnosed with the same cancer in the same year. The ratio ranges from 0 to 1, and the lower the value the longer one is expected to survive.  A MIR of 0 means no one dies of that particular cancer.

The 10 most common cancers in 2012, in terms of incidence, accounted for 71% of new cases. These cancers, listed below, have MIRs ranging from 0.13 to 0.90. That’s to say, some common cancers are 8 times as deadly as other common cancers.

Cancers aint cancers 1

 

In short, lung and pancreatic cancers have a much worse outlook than prostate, breast or melanomas.

 

Visualising MIR’s results

The MIR has a huge impact on how many people die from a particular cancer, compared to how many are diagnosed with it. For example, even though prostate cancer impacts 8 times as many people as pancreatic cancer (20,637 vs 2,383), both claimed roughly the same number of lives in 2012 (3,173 vs 2,437). The graph below shows the incidence and mortality of Australia’s 21 most common cancers.

Cancers aint cancers 2

 

How bad is bad: not as bad as it used to be

Huge improvements in survival rates are being made across most cancers. Over the past 30 years, 8 of the top 10 cancers saw large drops in mortality ratios. The two most common cancers, prostate and breast, are now less than half as deadly as they were in the early 1980s. Unfortunately, progress has been less effective for bladder cancer, which has in fact gone backwards, by 39%.

Cancers aint cancers 3

* 1982 MIRs are age-adjusted based on the 2012 population, to make the figures more comparable.

** Care must be taken when comparing colon and rectal cancers  over time, as it is likely that the figures are disturbed by coding changes, thus may not reflect real changes in survival rates

 

Neither me nor my mate’s mate get a say on which cancer they have, but it does help to know that treatments and support are improving every year.

Salud

 

 


Source:

All data used sourced from the AIHW’s Australian Cancer Incidence and Mortality (ACIM) books.

http://www.aihw.gov.au/acim-books/

 

Is a breast worth 15 lungs

Is a breast worth 15 lungs

Lung cancer is by far the biggest killing cancer in Australia. In 2014 it claimed the life of over 8,200 people. That’s almost as many as the next three cancers combined (prostate 3 102 + breast 2 844 + pancreas 2 547 = 8 493).

lungs-1

In popstats format, that’s one Australian death every hour.

Fortunately, much like pop, lung cancer’s mortality rate peaked in the early 80s, and has been declining steadily since.

 

Women catching up on the wrong race

This decrease, however, has been entirely gender lopsided.

While the anti-smoking initiatives have helped halve the mortality rate of men’s lung cancer since 1981, women’s has increased by 60% in the same period.

lungs-2

 

The increase in women dying of lung cancer has been so drastic that it has overtaken breast cancer as the biggest killer of women among all cancers. Back in the 1970s, breast cancer killed 4 times as many women as lung cancer.

lungs-3

 

Yet, lung cancer seems to be largely ignored (relatively speaking).

Research conducted by Cancer Australia, shows that even though lung cancer kills about 3 times as many as breast cancer, it receives less than a fifth of the research funding. Similar comparisons can be made with prostate and other cancers.  The graph below from their 2016 Cancer Research Review[1] provides a great representation of the inequality of research funding distribution currently in the field.

lungs-4

 

Lungs don’t sell

The communities’ disdain for lung cancer is also clear in the organizations we support. The Australian Charity and Not-for-profit Commission’s register includes 18 organisations mentioning “Breast cancer” by name, and another 15 mentioning “prostate cancer”.  Yet not one combined the words “lung” and “cancer” in their name[2].

This is not to say that there aren’t any organisations working in the area, but rather suggests that highlighting their cause is not considered a draw card.

 

Who’s to blame

Many suggest the community ignores lung cancer sufferers because a many of them are somewhat responsible for their condition. After all, smoking is linked with about 80%-90% of lung cancer sufferers[3]. But since when have we been so spiteful?

We help countless who have had a hand in their demise.

When the injured arrive at Emergency, triage forms don’t cover culpability.

We help those who drove too fast for the unexpected just as much as careful drivers who became their victims.

We help young men who go clubbing in Sydney, even if they threw the first punch.

People take all sorts of risks. Yet help is at hand when things don’t work out the way they hoped.

If James Dean does it

lungs-6

Not to mention that around 4 out of 5 sufferers took up smoking before the Vietnam War[4]; smoking warnings were not even a thing[5], and ads were the epitome of cool.

 

Not to mention the other 15%

That’s all without even thinking of the roughly 1,500 sufferers who never touched a smoke!

 

Heal the world

This, by the way, is a global phenomena. Lung cancer killed 1.6 million people worldwide in 2014 [7], yet similar under funding occurs across the major economies (or at least the ones I could find on a quick google search). So, any impact local research has in Australia could potentially help millions across the world.

 

So, why not?

Why not indeed.

In this age of cost-benefit analysis, we sometimes forget to put it into practice where it matters most. Lung cancer might be decreasing, but it sure isn’t going away. Smoking rates may have decreased, but they still haunt half as many as they did in the 80s[6]. At this rate, lunch cancer will still be the biggest killer for generations to come.

It’s time to stop victim blaming smokers, and put some money where are lungs are.

 

 


Disclosure:

The author is a reformed smoker… the worst kind.

 

Feature pic by hey_paul:

Human Lung Embroidery Wall Decor

 

References:

[1] https://canceraustralia.gov.au/system/tdf/publications/cancer-research-australia-2016-2018-opportunities-strategic-research-investment-summary/pdf/2016_research_review_highlights_final.pdf?file=1&type=node&id=4442

[2] Based on their 2014 data.

[3] http://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm

[4] Based on their age – over 65s in 2013.  And research showing 90% of smokers pick up the habit before the age of 20 (United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality. National Survey on Drug Use and Health, 2014. ICPSR36361-v1. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2016-03-22. http://doi.org/10.3886/ICPSR36361.v1.)

[5] http://www.tobaccoinaustralia.org.au/a12-1-1-history-health-warnings

[6] http://www.quit.org.au/resource-centre/facts-evidence/fact-sheets/smoking-rates

[7] http://www.who.int/mediacentre/factsheets/fs297/en/