Body section 8 (Cancer of the lung; Cancer Survival in Australia 2001)

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					8 Cancer of the lung

Summary
Cancer of the lung is the most common cancer in Australia and the world, and relative
survival after diagnosis remains very poor when compared with other cancers. During the
1992–1997 period, one-year relative survival proportions were 34.6% for males and 37.6% for
females. The five-year relative survival proportions fell to 11.0% for males and 14.0% for
females (Table 8.1). Survival ten years after diagnosis was only 8.2% for males and 9.2% for
females in 1987–1991, the most recent period for which ten-year relative survival data are
available (Tables 8.2 and 8.3).
Between 1982–1986 and 1992–1997 there was a slight but significant increase in the one-year
through to seven-year survival proportions for males and females. Five-year relative
survival increased by 1.7 percentage points for males and 2.2 percentage points for females
between 1982–1986 and 1992–1997 (Figure 8.2; Tables 8.2 and 8.3).
For lung cancers diagnosed within the period 1992–1997, five-year relative survival
proportions were highest for males and females aged below 30 years. Five-year relative
survival was significantly less for those aged 30–39 years—24.5% for males and 35.3% for
females. This decrease continued to 3.9% in males and 6.4% in females in the 80–89 age
group (Figure 8.3; Table 8.1).
There was a significant increase in five-year relative survival proportions between the
diagnosis periods 1982–1986 and 1992–1997 for males aged from 50–59 to 70–79 years and for
females aged 60–69 years. The other male and female age groups showed no significant
differences in relative survival between the diagnosis periods (Figure 8.3; Tables 8.5 and 8.6).

Table 8.1: Cancer of the lung: number of new cases and deaths, and five-year
relative survival proportions, by age at diagnosis and sex, Australia, 1992–1997

                                                                 5-year relative survival
                     New cases               Deaths                        (%)

Age                 Males    Females      Males     Females           Males      Females

0–19 years              5           8         2             2          60.1          75.1
20–29 years            29          19         7             7          76.2          62.9
30–39 years           156         144       118            93          24.5          35.3
40–49 years          1,081        809       913           641          14.9          19.9
50–59 years          4,079       1,939     3,483         1,590         14.4          17.6
60–69 years         10,251       3,916     9,089         3,308         11.9          15.6
70–79 years         10,974       4,577    10,102         4,118           9.0         10.6
80–89 years          3,718       1,790     3,613         1,706           3.9           6.4
90–99 years           252         150       248           146            6.4           8.9
All ages            30,545    13,352      27,575        11,611        11.0           14.0




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Incidence and mortality
There were 7,833 new cases of lung cancer diagnosed in 1997. Of these, 5,333 were males and
2,500 were females.
Lung cancer was the cause of 4,615 male deaths and 2,068 female deaths in 1997. It is
estimated that each year lung cancer is responsible for about 29,800 years of life lost in males
and 14,800 years of life lost in females before the age of 75.
For the six-year period 1992–1997, age-standardised incidence and mortality rates for lung
cancer in males decreased, with incidence falling by 1.5% per annum and mortality by 2.1%
per annum. Conversely, female age-standardised rates increased, with incidence increasing
by approximately 1.9% per annum and mortality by 1.4% per annum.



International comparisons
Lung cancer five-year relative survival proportions were poor in all the countries for which
relative survival data were available. In countries where data were available, five-year
relative survival after lung cancer was between 5% and 16%.
Five-year relative survival after diagnosis of lung cancer in Australia (14%), although quite
low compared with other cancers, was relatively high compared with relative survival after
lung cancer in other countries (Figure 8.3; Table 8.8).




   (a) Weighted average.

   Note: The survival period varies among countries, but is broadly within the 1987–1991 period.
   Sources: Ries et al. 1999; Coleman et al. 1999; Berrino et al. 1999.

   Figure 8.1: Cancer of the lung five-year relative survival proportions: selected countries




                                                                          37
 Males
 Relative survival (%)
 40

 35                                                                1992–1997


 30                                                                1987–1991

 25                                                                1982–1986

 20

 15

 10

  5

  0
      1       2          3   4       5         6         7     8       9        10

                                 Years after diagnosis


 Females
 Relative survival (%)
 40

 35                                                                1992–1997


 30                                                                1987–1991

 25                                                                1982–1986

 20

 15

 10

  5

  0
      1       2          3   4       5         6         7     8       9        10
                                 Years after diagnosis


Figure 8.2: Cancer of the lung relative survival proportions: period of diagnosis,
Australia




                                               38
   Males
   Survival proportion (%)

   100
                                                                                                 1982–1986

                                                                                                 1987–1991
    80

                                                                                                 1992–1997

    60



    40



    20



     0
           0–19      20–29     30–39      40–49      50–59       60–69   70–79   80–89   90–99
                                          Age at diagnosis


   Females
   Survival proportion (%)

  100
                                                                                                 1982–1986

                                                                                                 1987–1991
   80
                                                                                                 1992–1997


   60



   40



   20



    0
          0–19      20–29      30–39     40–49 50–59 60–69               70–79   80–89   90–99
                                         Age at diagnosis

  Note: 95% confidence intervals are shown for each age group.

  Figure 8.3: Cancer of the lung five-year relative survival proportions: age at diagnosis by period
  of diagnosis, Australia




Small-cell carcinoma of the lung
Five-year relative survival after a diagnosis of small-cell carcinoma of the lung was very
poor when compared with non-small-cell carcinoma of the lung. For the period 1992–1997,


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one-year relative survival after diagnosis of small-cell carcinoma of the lung was 28.3% for
males and 33.7% for females. Relative survival five years after diagnosis was only 4.8% in
males and 5.4% in females (Figure 8.4; Tables 8.9 and 8.10).
For small-cell carcinomas of the lung diagnosed between 1992 and 1997, five-year relative
survival was highest in the 30–39 age group for males and in the 50–59 age group for females
at 9.5% and 9.8% respectively. As age increased from age group 50–59, five-year relative
survival dropped steadily to 1.6% at age 80–89 years for both males and females (Tables 8.11
and 8.12).



Survival by subtypes

Non-small-cell carcinoma of the lung
Five-year relative survival after diagnosis of non-small-cell carcinoma of the lung was
higher than for small-cell carcinoma of the lung. For the period 1992–1997, one-year relative
survival for those diagnosed with non-small-cell carcinomas of the lung was about 35.6% for
males and 38.4% for females. Five-year relative survival was 12.0% for males and 15.8% for
females (Figure 8.4; Tables 8.13 and 8.14).
Five-year relative survival declined steadily as age increased. Both males and females aged
20–29 years had the highest five-year relative survival, at 81.8% and 62.9% respectively. This
decreased to 4.1% for males and 7.0% for females aged 80-89 years (Tables 8.15 and 8.16).


Adenocarcinoma of the lung
Five-year relative survival after diagnosis of adenocarcinoma of the lung was higher when
compared with relative survival after diagnosis of all non-small-cell carcinoma of the lung.
One-year relative survival for those diagnosed with adenocarcinoma of the lung was 37.9%
for males and 46.6% for females for the period 1992–1997. Five-year relative survival was
13.7% for males and 20.5% for females (Figure 8.4; Tables 8.17 and 8.18).
During the diagnosis period 1992–1997, five-year relative survival decreased steadily as age
increased. The numbers of new cases and deaths were small for age groups under 30 years,
making relative survival estimates for these age groups less robust. For those aged 30–39
years, five-year relative survival was 16.2% for males and 29.3% for females. Five-year
relative survival decreased to 7.2% for males and 13.7% for females aged 80–89 years (Tables
8.19 and 8.20).




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Figure 8.4: Cancer of the lung five-year relative survival proportions: by morphology,
Australia, 1992–1997




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Description: Body section 8 (Cancer of the lung; Cancer Survival in Australia 2001)