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Temporal changes in loss of life expectancy due to cancer in Australia: a flexible parametric approach

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Abstract

Purpose

To evaluate changes in cancer mortality burden over time by assessing temporal trends in life expectation for Australian residents diagnosed with cancer.

Methods

The study cohort consisted of all people diagnosed with cancer in the period 1990–2000 and aged 15–89 years (n = 1,275,978), with mortality follow-up to 31 December 2010. Flexible parametric survival models incorporating background age–sex–year-specific population mortality rates were applied to generate the observed survival curves for all cancers combined and selected major cancer types. Predicted values of loss of life expectancy (LOLE) in years were generated and then averaged across calendar year and age group (15–49, 50–69 and 70–89 years) or spread of disease (localized, regional, distant, unknown).

Results

The greatest LOLE burden was for lung cancer (14.3 years per diagnosis) and lowest for melanoma (2.5 years). There was a significant decrease in LOLE over time (−0.13 LOLE per year) for all cancers combined. Decreases were also observed for female breast cancer (−0.21), prostate cancer (−0.17), colorectal cancer (−0.08), melanoma (−0.07) and stomach cancer (−0.02), with slight increases for lung cancer (+0.04). When restricted to the sub-cohort from New South Wales with spread of disease information, these decreases in LOLE were primarily among cancers categorized as localized or regional spread at diagnosis.

Conclusions

In Australia, persons diagnosed with cancer have a steadily improving outlook that exceeds that expected by general improvement in population life expectancy. The overall improvement is observed in persons with localized or regional cancers but not in those with advanced cancers, findings which encourage earlier diagnosis.

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Acknowledgments

We thank the staff of the State and Territory Cancer Registries and the Australian Cancer database, from which these study data were obtained.

Funding

Philippa Youl is funded by a National Health and Medical Research Council Early Career Fellowship (#1054038). The funding body had no input into the study design, the collection, analysis and interpretation of data, the writing of the report or the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. Cancer Council Queensland, Brisbane, QLD, 4006, Australia

    Peter D. Baade, Danny R. Youlden, Philippa H. Youl, Michael G. Kimlin & Joanne F. Aitken

  2. School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, 4059, Australia

    Peter D. Baade, Philippa H. Youl, Michael G. Kimlin, Joanne F. Aitken & Robert J. Biggar

  3. Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia

    Peter D. Baade & Philippa H. Youl

  4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 76, Stockholm, Sweden

    Therese M. Andersson

  5. Division of Cancer Services, Princess Alexandra Hospital, Brisbane, QLD, 4102, Australia

    Euan T. Walpole

  6. AusSun Research Laboratory, University of the Sunshine Coast, Sunshine Coast, QLD, 4556, Australia

    Michael G. Kimlin & Robert J. Biggar

Authors
  1. Peter D. Baade
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  2. Danny R. Youlden
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  4. Philippa H. Youl
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  6. Michael G. Kimlin
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Corresponding author

Correspondence to Peter D. Baade.

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Conflict of interest

The authors report no conflict of interest.

Ethical approval

Approval for the use of the anonymized data was provided by all of the individual State and Territory Cancer Registries through the Australian Institute of Health and Welfare (AIHW), with the exception of the Australian Capital Territory (ACT).

Informed consent

Since no individuals were identified nor able to be contacted, informed consent was not required.

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Baade, P.D., Youlden, D.R., Andersson, T.M. et al. Temporal changes in loss of life expectancy due to cancer in Australia: a flexible parametric approach. Cancer Causes Control 27, 955–964 (2016). https://doi.org/10.1007/s10552-016-0762-1

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  • DOI: https://doi.org/10.1007/s10552-016-0762-1

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