Cancer in the Northern Territory
Introduction
Cancer incidence and mortality are important population health outcomes. This fact sheet updates previous Northern Territory (NT) cancer reports 1-3 to provide long term trends in cancer incidence and mortality between 1991 and 2018. Four data sources were used for this fact sheet: NT cancer data (NT Cancer Registry), Australian cancer data (Australian Institute of Health and Welfare), mortality data (Australian Coordinating Registry) and population data (Australian Bureau of Statistics). 4-6 The NT population data are estimates of the resident population by age, sex, Indigenous status and health district (1971- 2019).7 Population data used in this fact sheet differ from previous cancer reports; consequently, caution is advised when comparing rates provided here with rates provided in previous NT cancer reports.
All cancer incidence
Age-standardised incidence of all cancers combined among NT residents was generally lower than all Australians. In all population groups, cancer incidence was markedly higher in males than in females (Table 1).
Table 1. All cancers combined, age-standardisedincidence rate, by 5-year period, Indigenous status and sex, NT and Australia, 1991–2018
Five-year periods
Northern Territory Australia Aboriginal Non-Aboriginal
No. Rate No. Rate Rate
Male
1991-1995 135 455.8 719 500.1 573.8
1996-2000 177 612.7 978 485.5 558.1
2001-2005 230 536.9 1,227 509.8 578.7 2006-2010 296 517.8 1,581 545.2 611.6 2011-2015 347 496.7 1,885 537.2 576.9
2016-2018 209 413.3 1,191 505.3 565.2
Female
1991-1995 153 316.7 550 427.2 384.0
1996-2000 198 411.8 669 377.6 396.9
2001-2005 239 336.1 785 349.0 406.9
2006-2010 325 387.1 947 359.3 412.5
2011-2015 395 439.1 1,271 415.0 426.9
2016-2018 255 350.1 856 403.9 432.5
Cancer mortality
For the most part, age-standardised cancer mortality rates of Territorians were similar to the national average among non-Aboriginal males and females, but considerably higher among Aboriginal males and females (Table 2).
Table 2. All cancers combined, age-standardised mortality rate, by 5-year period, Indigenous status and sex, NT and Australia, 1991–2018
Five-year periods
Northern Territory Australia Aboriginal Non-Aboriginal
No. Rate No. Rate Rate
Male
1991-1995 122 477.7 354 298.1 275.6
1996-2000 123 486.2 375 233.5 258.0
2001-2005 170 426.7 403 214.8 239.3
2006-2010 181 362.6 569 266.4 225.0
2011-2015 233 404.9 629 234.0 205.9
2016-2018 149 350.2 388 211.5 194.5
Female
1991-1995 111 249.6 183 199.8 162.5
1996-2000 124 320.6 227 178.7 154.3
2001-2005 123 235.4 224 144.0 147.4
2006-2010 173 233.9 266 145.2 139.5
2011-2015 236 308.9 338 137.5 132.2
2016-2018 140 248.1 237 146.4 126.8
Notes: Incidence and mortality rates are expressed as the number of new cases or deaths per 100,000 population and standardised to the 2001 Australian Estimated Resident Population.
Most common cancers
The most common cancer sites among NT Aboriginal males were cancer of the lung followed by liver and oral cavity. In contrast, the most common cancer sites among NT non-Aboriginal males were prostate followed by lung and bowel.
The most common cancer sites among NT Aboriginal females were breast followed by lung and unknown primary, whereas for NT non-Aboriginal females, the most common cancer sites were breast followed by bowel and melanoma.
Table 3. Age-standardised incidence rates, by cancer site, sex and Indigenous status, NT, 2011–2018
Cancer
Male Female
Aboriginal Non-
Aboriginal Aboriginal Non- Aboriginal
Lung 106.9 69.7 50.7 36.9
Liver 60.5 9.6 13.6 2.4
Oral cavity* 54.0 24.7 15.1 7.0
Unknown primary 42.2 18.9 29.6 15.2
Prostate 35.6 118.0 - -
Bowel 25.8 62.1 16.5 51.7
Pancreas 18.8 11.5 13.9 7.9
Oesophagus 18.1 9.7 3.3 4.1
Kidney 17.3 31.0 6.9 12.2
Gallbladder 13.3 3.5 16.1 3.4
Stomach 11.4 9.3 6.5 3.9
Leukaemia 11.1 14.3 12.4 10.0
Larynx 10.5 9.7 3.6 0.7
Thyroid 8.6 3.4 13.5 6.9
Non-Hodgkin 5.6 15.1 7.2 11.5
Lymphoid 5.5 7.8 2.9 5.2
Myeloma 3.8 5.0 1.1 3.7
Brain 3.6 7.0 4.7 4.8
Other digestive 3.2 1.9 1.9 2.4
Other respiratory 3.0 1.1 2.0 0.8
Melanoma 2.6 52.7 1.4 37.3
Male genital 2.5 1.2 - -
Anus 2.2 0.9 2.5 1.5
Soft tissue 2.0 4.6 2.4 2.7
Testis 1.9 5.5 - -
Hodgkin 1.5 2.2 0.6 1.8
Non-melanoma 1.1 2.6 0.5 1.0
Lip 1.1 6.6 0.9 2.0
Bone 1.0 0.9 0.7 0.8
Mesothelioma 1.0 4.3 0.6 0.3
Others* 0.4 1.7 0.8 0.8
Endocrine glands 0.1 0.5 0.1 0.4
Female breast - - 72.2 108.1
Cervix - - 22.9 9.6
Female genital* - - 18.8 11.9
Uterus - - 22.2 15.8
*Oral cavity = Oral cavity and pharynx
*Brain = Brain & central nervous system
*Others = Malignant neoplasms ill-defined & unspecified sites
*Female genital = Ovary, vulva & other female genital organs
Trends in most common cancers
Table 3 shows trends for the most common cancers in the NT population by sex and Indigenous status.
Prostate and female breast cancer rates were the highest, exceeding all other cancers. Prostate cancer rates were slightly higher than female breast cancer
rates with the exception of Aboriginal males for whom prostate cancer is an uncommon cancer.
Figure 1. Cancer of the breast, age-standardised incidence rate, females, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 2. Cancer of the prostate, age-standardised incidence rate, males, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 3. Cancer of the lung, age-standardised incidence rate, males, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 4. Cancer of the lung, age-standardised incidence rate, females, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 5. Cancer of the bowel, age-standardised incidence rate, males, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 6. Cancer of the bowel, age-standardised incidence rate, females, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 7. Cancer of the oral cavity, age-standardised incidence rate, males, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 8. Cancer of the oral cavity, age-standardised incidence rate, females, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 9. Melanoma of the skin, age-standardised incidence rate, males, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 10. Melanoma of the skin, age-standardised
incidence rate, females, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 11. Cancer of the liver, age-standardised incidence rate, males, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Figure 12. Cancer of the liver, age-standardised incidence rate, females, by 2-year period, Indigenous status, NT and Australia, 1991–2018
Between 1991 and 2018, breast cancer incidence increased slightly among NT non-Aboriginal and Australian women, whereas among NT Aboriginal women incidence fluctuated greatly (Figure 1). Rates among female Territorians were generally lower than Australia.
Prostate cancer incidence among NT Aboriginal men fluctuated due to small numbers in contrast to a slight increase among NT non-Aboriginal and Australian males during the same period (Figure 2).
Lung cancer incidence decreased among all population groups except Australian females (Figures 3 and 4).
The greatest decline occurred among Aboriginal Territorians for whom lung cancer rates have fallen considerably since the early 1990s.
Bowel cancer incidence in NT males, both Aboriginal and non-Aboriginal increased slightly, in contrast to a marked decline among Australian males (Figures 5 and 6). This trend was opposite for NT non-Aboriginal females who experienced a decline in bowel cancer incidence, similar to Australian females. Bowel cancer is an uncommon cancer among Aboriginal females.
Trends in oral cavity cancer incidence did not change over time among all males, despite marked
fluctuations in rates among NT Aboriginal males.
Among females, oral cavity cancer is far less common;
than males and therefore challenging to provide comparable graphical representations (Figures 7 and 8). There was however, a marked increase in rates over time for NT Aboriginal females.
Melanoma of the skin is a very uncommon cancer among Aboriginal Territorians, whereas for non- Aboriginal Territorians and the Australian mainstream population, this type of cancer is much more
prevalent. For both males and females in these population groups, melanoma incidence almost doubled over the entire time period, 1991 and 2018, particularly among males (Figures 9 and 10).
Liver cancer is another cancer where there are marked differences in incidence between males and females, (Figures 11 and 12). Both NT Aboriginal males and females experienced a marked increase in this type of cancer in recent years, whereas non-Aboriginal and Australian rates remained low and relatively stable over the entire study period.
Snapshot of cancer incidence in 2018
The most common types of cancers in the NT in 2018 are listed in Table 4. A total of 811 new cases of cancer were diagnosed in NT in 2018 (excludes basal and squamous cell carcinomas of the skin and in-situ cancers (cervix, breast, bladder and melanoma).
Table 4. Incidence by cancer site and Indigenous status, NT, 2018
Cancer site
Aboriginal
Non-
Aboriginal Total
Lung* 25 57 82
Liver 16 18 34
Breast* 15 94 109
Uterus & ovary* 14 21 35
Bowel 10 68 78
Oral cavity* 10 30 40
Unknown primary 9 23 32
Kidney* 8 28 36
Prostate 7 86 93
Gallbladder & bile duct 7 1 8
Stomach* 6 16 22
Thyroid 6 16 22
Leukaemia 5 10 15
Pancreas 4 17 21
Lymphoid tissues* 3 16 19
Oesophagus 3 12 15
Melanoma of skin 1 72 73
Non-Hodgkin lymphoma 1 22 23
Brain & central nervous 1 11 12
Testis & penis* 1 6 7
Mesothelioma 1 5 6
Others* 1 3 4
Hodgkin lymphoma 1 2 3
Bone & articular cartilage 1 1 2
Soft tissues 0 10 10
Myeloma 0 8 8
Non-melanoma skin cancer 0 2 2
Total 156 655 811
*Lung = Lung & other respiratory & intrathoracic organs
*Breast = male & female breast
*Uterus & ovary = Uterus, ovary & other female genital organs
*Oral cavity = Lip, larynx, oral cavity & pharynx
*Kidney = Kidney, bladder & other urinary organs
*Stomach =Stomach & other digestive organs
*Lymphoid tissues = other lymphoid & haematopoietic tissues
*Others = Anus & eye
References
1. Zhang X, Dugdale S, Warton L, Qin Li SQ. Cancer in the Northern Territory 1991-2015 incidence and mortality. Department of Health, Darwin, 2021.
2. Zhang X, Condon J, Dempsey K, Garling L. Cancer in the Northern Territory 1991–2010: incidence, mortality and survival. Department of Health, Darwin, 2014
3. Zhang X, Condon J, Dempsey K & Garling L.
Cancer incidence and mortality, Northern Territory 1991–2005. Department of Health and Families, Darwin, 2008
4. Australian Institute of Health Welfare (2021).
Cancer Data in Australia Cat.no. CAN 122.
Accessed 1 Nov 2021
.
Cancer data in Australia, Data - Australian Institute of Health and Welfare (aihw.gov.au)5. Australian Coordinating Registry (ACR). Australian Bureau of Statistics (ABS). Cause of death unit record file data. Prior to 2005 data was supplied by the ABS and from 2006 to 2014 by the ACR.
6. Australian Bureau of Statistics (2021). National, state and territory population. Accessed 1 Nov 2021National, state and territory population, June 2021 | Australian Bureau of Statistics (abs.gov.au)
7. Department of Health. Northern Territory resident population estimates by age, sex, Indigenous status and health districts (1971- 2019). Updated on 10 August 2020. Darwin:
Population and Digital Health Branch, 2019.
Information compiled by:
Renu Unnikrishnan and Shu Qin Li
Enquiries to:
Population and Digital Health Branch Northern Territory Health
PO Box 40596, Casuarina NT 0811 Email: [email protected]
Population and Digital Health Fact Sheet, March 2022
