Skip to content
Please select category from the dropdown list below.
Cancer is the term used for a variety of diseases that cause damage to the genetic blueprint (DNA) of the cells resulting in uncontrolled growth (cells normally grow and multiply in a controlled manner) . If damaged cells spread into surrounding areas, or to different parts of the body (metastasise), they are known as malignant. Cancerous cells can arise from almost any cell, so cancer can occur almost anywhere in the body.
Until recently, the impact of cancer on Aboriginal and Torres Strait Islander people has attracted much less attention than it deserves; there are two main reasons for this. First, the level of identification of Indigenous people in cancer notifications is known to be incomplete . Identification in the cancer registries has been improving  but due to incompleteness of Indigenous identification for cancer notifications in several jurisdictions, currently there is no overall national information on cancer incidence among Indigenous people. Provision for the identification of Indigenous people is not yet included on all pathology forms and when it is recorded the information may not always be transferred to cancer registries . Second, cancer has often been reported in terms of the proportions of deaths it causes rather than by rates; the comparison of proportions of deaths under-estimates the relative impact of cancer on Indigenous people.
In the five-year period 2005-2009, an average of 840 Indigenous people living in NSW, Qld, WA and the NT were diagnosed with cancer each year . After age-adjustment, the cancer incidence rate was slightly lower for Indigenous people than for non-Indigenous people (421 and 443 per 100,000 people, respectively).24
Details are available for males and females for the five year period 2004-2008. Cancer incidence rates were significantly higher for males than for females for both the Indigenous and non-Indigenous populations . After age-adjustment, the rates for Indigenous people were slightly higher than those for non-Indigenous people for both males (549 and 525 per 100,000, respectively) and females (400 and 361 per 100,000, respectively). These rates were significantly different for females, but not for males.
For 2005-2009 in NSW, Qld, WA and NT, after age-adjustment, the incidence rates were significantly higher for Indigenous people than non-Indigenous people for: liver cancer (rate ratio 2.8); cervical cancer (rate ratio 2.3); cancer of unknown primary site (rate ratio 1.8); lung cancer (rate ratio 1.7); and uterine cancer (rate ratio 1.6) . The incidence of pancreatic cancer was also higher for Indigenous people than non-Indigenous people (rate ratio 1.3). After age-adjustment, cancer incidence rates were lower for Indigenous people than non-Indigenous people for: colorectal cancer (rate ratio 0.8); breast cancer in females (rate ratio 0.7); non-Hodgkin lymphoma (0.7); and prostate cancer (0.6).
For 2005-2009, detailed information is available for the incidence of cervical and breast cancers for Indigenous people living in NSW, Qld, WA and NT. After age-adjustment, the rate for cervical cancer among Indigenous women was higher than for non-Indigenous women (16.9 and 6.5 per 100,000 respectively) , and for breast cancer significantly lower than for non-Indigenous women (85 and 105 per 100,000 respectively) . Despite the lower rate for breast cancer it is still the most common cancer diagnosed for Indigenous women in NSW, Qld, WA and NT.
More details are available for 2004-2008 where the most common cancer diagnosed among Indigenous people living in NSW, Qld, WA and the NT was lung cancer (average of 121 cases per year), followed by breast cancer (females only) (average of 88 cases per year), bowel cancer (average of 70 cases per year) and prostate cancer (males only) (average of 58 per year) . The highest Indigenous:non-Indigenous rate ratios were for liver cancer (rate ratio 3.0), cancer of the cervix (2.8), lung cancer (1.9) and cancer of unknown site (1.9) (Table 19).
|Site of primary cancer||Indigenous people||Non-Indigenous people||Rate ratio|
|Source: AIHW and Australasian Association of Cancer Registries, 2013 |
|Unknown primary site||24||12||1.9|
There were 3,490 hospital separations for cancer among Indigenous people in 2012-13 . The age-standardised hospitalisation rates for cancer for Indigenous people were lower than for their non-Indigenous counterparts (10 and 15 per 1,000, respectively).
In terms of specific cancers, the age-standardised hospitalisation rate for lung cancer and cervical cancer for Indigenous people in 2012-13 were 1.8 and 1.6 times respectively higher than those for their non-Indigenous counterparts . Hospitalisation rates for lung cancer were similar for Indigenous males and females (1.3 per 1,000) and higher for non-Indigenous males than females (0.9 per 1,000 and 0.5 per 1,000 respectively).
Cancer was responsible for one-in-five deaths (524 deaths) of Indigenous people living in NSW, Qld, SA, WA and the NT in 2012 . After age-adjustment, the death rate for Indigenous people was 1.5 times higher than for their non-Indigenous counterparts. Cancers of the trachea, bronchus and lung cancers were the third leading cause of death for Indigenous people (138 deaths: 77 males and 61 females), with the overall death rate 2.3 times higher than for non-Indigenous people.
In the five-year period 2008-2012, there was an average of 459 deaths from cancer per year among Indigenous people living in NSW, Qld, WA, SA and the NT . After age-adjustment, the mortality rate of all cancers combined for Indigenous people was significantly higher than for non-Indigenous people (221 and 172 per 100,000 respectively, rate ratio 1.3). Lung cancer accounted for the highest average number of cancer-related deaths for Indigenous people with 115 deaths per year (25% of all Indigenous deaths from cancer), followed by liver cancer with 34 deaths (7%), breast cancer in females with 30 deaths (6%) and cancer of unknown primary site with 27 deaths (6%).
For 2008-2012, after age-adjustment, mortality rates in NSW, Qld, WA, SA and the NT were significantly higher for Indigenous people than for non-Indigenous people for: cervical cancer (rate ratio 3.4); liver cancer (rate ratio 3.0); lung cancer (rate ratio 1.7); and cancer of unknown primary site (rate ratio 1.5) . Mortality rates for uterine cancer (rate ratio 1.6), pancreatic cancer (1.2), and breast cancer in females (1.1) were also higher for Indigenous people than non-Indigenous people but the differences were not statistically significant . Mortality rates were lower for Indigenous people than non-Indigenous people for non-Hodgkin lymphoma (rate ratio 0.9), colorectal cancer (rate ratio 0.8) and prostate cancer (rate ratio 0.8), but the differences were not statistically significant.
More details are available for 2007-2011 when, in terms of specific cancers, the annual average numbers of cancer-related deaths among Indigenous people living in NSW, Qld, WA, SA and the NT in 2007-2011 were: 110 from lung cancer; 29 from liver cancer; 28 from breast cancer (among women); 26 from cancer of unknown site; and 24 from bowel cancer . The highest Indigenous:non-Indigenous death rate ratios were for cancer of the cervix (rate ratio 3.9), liver cancer (3.3), cancer of the oesophagus (2.3), lung cancer (1.9), and stomach cancer (1.7) (Table 20). After age-adjustment, the death rate for cancer was 1.5 times higher for Indigenous people than for their non-Indigenous counterparts.
|Site of primary cancer||Indigenous people||Non-Indigenous people||Rate ratio|
|Source: AIHW and National Mortality Database, 2013 |
|Unknown primary site||16||10||1.6|
The patterns of Indigenous cancer incidence and mortality are largely explained by the higher level of risk factors, most notably tobacco use . For example, high rates of smoking are the likely cause of a high incidence of cancers of the lung, mouth and throat.
The higher Indigenous:non-Indigenous rate ratio for deaths from cancer than for cancer incidence could be due to a number of factors: