Is the risk of cancer in Australia overstated? The importance of competing mortality for estimating lifetime risk

Anthea C Bach, Kelvin Se Lo, Thanya Pathirana, Paul P Glasziou, Alexandra L Barratt, Mark A Jones, Katy Jl Bell

Research output: Contribution to journalArticleResearchpeer-review

Abstract

OBJECTIVES: To calculate lifetime risks of cancer diagnosis and cancer-specific death, adjusted for competing mortality, and to compare these estimates with the corresponding risks published by the Australian Institute of Health and Welfare (AIHW).

DESIGN, SETTING: Analysis of publicly available annual AIHW data on age-specific cancer incidence and mortality - for breast cancer, colorectal cancer, prostate cancer, melanoma of the skin, and lung cancer - and all-cause mortality in Australia, 1982-2013.

OUTCOME MEASURES: Lifetime risks of cancer diagnosis and mortality (to age 85), adjusted for competing mortality.

RESULTS: During 1982-2013, AIHW estimates were consistently higher than our competing mortality-adjusted estimates of lifetime risks of diagnosis and death for all five cancers. Differences between AIHW and adjusted estimates declined with time for breast cancer, prostate cancer, colorectal cancer, and lung cancer (for men only), but remained steady for lung cancer (women only) and melanoma of the skin. In 2013, the respective estimated lifetime risks of diagnosis (AIHW and adjusted) were 12.7% and 12.1% for breast cancer, 18.7% and 16.2% for prostate cancer, 9.0% and 7.0% (men) and 6.4% and 5.5% (women) for colorectal cancer, 7.5% and 6.0% (men) and 4.4% and 4.0% (women) for melanoma of the skin, and 7.6% and 5.8% (men) and 4.5% and 3.9% (women) for lung cancer.

CONCLUSION: The method employed in Australia to calculate the lifetime risks of cancer diagnosis and mortality overestimates these risks, especially for men.

Original languageEnglish
Number of pages6
JournalThe Medical journal of Australia
DOIs
Publication statusE-pub ahead of print - 6 Nov 2019

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Lung Neoplasms
Prostatic Neoplasms
Mortality
Neoplasms
Health
Colorectal Neoplasms
Melanoma
Skin Neoplasms
Breast Neoplasms
Skin
Incidence

Cite this

@article{154e354e07c648cd979ade69e89034be,
title = "Is the risk of cancer in Australia overstated? The importance of competing mortality for estimating lifetime risk",
abstract = "OBJECTIVES: To calculate lifetime risks of cancer diagnosis and cancer-specific death, adjusted for competing mortality, and to compare these estimates with the corresponding risks published by the Australian Institute of Health and Welfare (AIHW).DESIGN, SETTING: Analysis of publicly available annual AIHW data on age-specific cancer incidence and mortality - for breast cancer, colorectal cancer, prostate cancer, melanoma of the skin, and lung cancer - and all-cause mortality in Australia, 1982-2013.OUTCOME MEASURES: Lifetime risks of cancer diagnosis and mortality (to age 85), adjusted for competing mortality.RESULTS: During 1982-2013, AIHW estimates were consistently higher than our competing mortality-adjusted estimates of lifetime risks of diagnosis and death for all five cancers. Differences between AIHW and adjusted estimates declined with time for breast cancer, prostate cancer, colorectal cancer, and lung cancer (for men only), but remained steady for lung cancer (women only) and melanoma of the skin. In 2013, the respective estimated lifetime risks of diagnosis (AIHW and adjusted) were 12.7{\%} and 12.1{\%} for breast cancer, 18.7{\%} and 16.2{\%} for prostate cancer, 9.0{\%} and 7.0{\%} (men) and 6.4{\%} and 5.5{\%} (women) for colorectal cancer, 7.5{\%} and 6.0{\%} (men) and 4.4{\%} and 4.0{\%} (women) for melanoma of the skin, and 7.6{\%} and 5.8{\%} (men) and 4.5{\%} and 3.9{\%} (women) for lung cancer.CONCLUSION: The method employed in Australia to calculate the lifetime risks of cancer diagnosis and mortality overestimates these risks, especially for men.",
author = "Bach, {Anthea C} and Lo, {Kelvin Se} and Thanya Pathirana and Glasziou, {Paul P} and Barratt, {Alexandra L} and Jones, {Mark A} and Bell, {Katy Jl}",
note = "{\circledC} 2019 AMPCo Pty Ltd.",
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day = "6",
doi = "10.5694/mja2.50376",
language = "English",
journal = "Medical Journal of Australia",
issn = "0025-729X",
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Is the risk of cancer in Australia overstated? The importance of competing mortality for estimating lifetime risk. / Bach, Anthea C; Lo, Kelvin Se; Pathirana, Thanya; Glasziou, Paul P; Barratt, Alexandra L; Jones, Mark A; Bell, Katy Jl.

In: The Medical journal of Australia, 06.11.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Is the risk of cancer in Australia overstated? The importance of competing mortality for estimating lifetime risk

AU - Bach, Anthea C

AU - Lo, Kelvin Se

AU - Pathirana, Thanya

AU - Glasziou, Paul P

AU - Barratt, Alexandra L

AU - Jones, Mark A

AU - Bell, Katy Jl

N1 - © 2019 AMPCo Pty Ltd.

PY - 2019/11/6

Y1 - 2019/11/6

N2 - OBJECTIVES: To calculate lifetime risks of cancer diagnosis and cancer-specific death, adjusted for competing mortality, and to compare these estimates with the corresponding risks published by the Australian Institute of Health and Welfare (AIHW).DESIGN, SETTING: Analysis of publicly available annual AIHW data on age-specific cancer incidence and mortality - for breast cancer, colorectal cancer, prostate cancer, melanoma of the skin, and lung cancer - and all-cause mortality in Australia, 1982-2013.OUTCOME MEASURES: Lifetime risks of cancer diagnosis and mortality (to age 85), adjusted for competing mortality.RESULTS: During 1982-2013, AIHW estimates were consistently higher than our competing mortality-adjusted estimates of lifetime risks of diagnosis and death for all five cancers. Differences between AIHW and adjusted estimates declined with time for breast cancer, prostate cancer, colorectal cancer, and lung cancer (for men only), but remained steady for lung cancer (women only) and melanoma of the skin. In 2013, the respective estimated lifetime risks of diagnosis (AIHW and adjusted) were 12.7% and 12.1% for breast cancer, 18.7% and 16.2% for prostate cancer, 9.0% and 7.0% (men) and 6.4% and 5.5% (women) for colorectal cancer, 7.5% and 6.0% (men) and 4.4% and 4.0% (women) for melanoma of the skin, and 7.6% and 5.8% (men) and 4.5% and 3.9% (women) for lung cancer.CONCLUSION: The method employed in Australia to calculate the lifetime risks of cancer diagnosis and mortality overestimates these risks, especially for men.

AB - OBJECTIVES: To calculate lifetime risks of cancer diagnosis and cancer-specific death, adjusted for competing mortality, and to compare these estimates with the corresponding risks published by the Australian Institute of Health and Welfare (AIHW).DESIGN, SETTING: Analysis of publicly available annual AIHW data on age-specific cancer incidence and mortality - for breast cancer, colorectal cancer, prostate cancer, melanoma of the skin, and lung cancer - and all-cause mortality in Australia, 1982-2013.OUTCOME MEASURES: Lifetime risks of cancer diagnosis and mortality (to age 85), adjusted for competing mortality.RESULTS: During 1982-2013, AIHW estimates were consistently higher than our competing mortality-adjusted estimates of lifetime risks of diagnosis and death for all five cancers. Differences between AIHW and adjusted estimates declined with time for breast cancer, prostate cancer, colorectal cancer, and lung cancer (for men only), but remained steady for lung cancer (women only) and melanoma of the skin. In 2013, the respective estimated lifetime risks of diagnosis (AIHW and adjusted) were 12.7% and 12.1% for breast cancer, 18.7% and 16.2% for prostate cancer, 9.0% and 7.0% (men) and 6.4% and 5.5% (women) for colorectal cancer, 7.5% and 6.0% (men) and 4.4% and 4.0% (women) for melanoma of the skin, and 7.6% and 5.8% (men) and 4.5% and 3.9% (women) for lung cancer.CONCLUSION: The method employed in Australia to calculate the lifetime risks of cancer diagnosis and mortality overestimates these risks, especially for men.

U2 - 10.5694/mja2.50376

DO - 10.5694/mja2.50376

M3 - Article

JO - Medical Journal of Australia

JF - Medical Journal of Australia

SN - 0025-729X

ER -