Cancer diagnosis numbers set to skyrocket by 50 percent over next two decades

• People are surviving longer after cancer diagnosis - but New Zealand is not improving as fast as other high-income countries.
• Māori around 1.6 times more likely, and Pacific peoples 1.4 times more likely, to die from cancer than Pākehā /other ethnicity.
• Up to half of all cancers "preventable": improved prevention efforts could see between 8000 and 14,000 fewer cancer diagnoses each year.

The number of New Zealanders diagnosed with cancer each year is set to skyrocket by 50 percent in the next two decades to more than 45,000.

That is according to a snapshot of the State of Cancer report over the last five years, released on Thursday by Te Aho o Te Kahu | Cancer Control Agency.

The agency's chief executive, Rami Rahal, said the projected increase - from about 30,000 new cases this year, to over 45,000 by 2044 - underscored the need for ongoing investment to ensure the health system was ready.

"We cannot respond to this big increase in demand by doing more of the same," he said.

"We need new and innovative ways of delivering care and preventing cancers."

Since the first State of Cancer report five years ago, there had been "encouraging progress" in key areas of prevention, early detection and treatment, he said.

"The chance of surviving cancer has improved over the last 20 years. Smoking rates are declining across all ethnicities, and our national screening programmes are becoming more effective and accessible.

"However, much work is still needed."

That included the need for "sustained, targeted action" on reducing ethnic disparities: Māori were around 1.6 times more likely, and Pacific peoples 1.4 times more likely, to die from cancer than people of European/other ethnicity.

"Addressing inequities must remain a system-wide priority," Rahal said.

"Everyone in New Zealand deserves the same access to treatment and chance of cure."

The Cancer Control Agency was currently working with the sector to update the New Zealand Cancer Action Plan 2019-2029, which was set to be published early next year.

Rahal told Morning Report mortality rates were decreasing.

"We have improved the five year survival which is the percentage of being alive five years after being diagnosed from 58 percent to 68 percent."

Rahal said there's still work to be done to get to the five year survival rate in Australia - which was 73 percent.

He said as the population ages there were more people at the age range where cancer was prevalent.

"That's why we are seeing the numbers go up from 30,000 this year to 45,000, which is actually a wake up call for us because if we are struggling as a system to deliver on the needs of 30,000 people we need to be prepared for that."

One of the ways the agency wanted to innovate in treatment to improve was to train nurses to do a bit of the work that cancer doctors do, he said.

"Do more perscribing, do more delivery of cemotheropy, do more follow-up clinics. We have more opportunities to train nurses to endoscopies and colposcopies."

Rahal said they could not hire enough doctors to deal with the increase of cancer patients.

Other findings from the report:

• Most-diagnosed cancers in New Zealand: prostate, breast, bowel, melanoma and lung cancer.
• Cancer incidence rates have dropped in the last 20 years, but only by 5 percent overall - and that decrease has levelled off over the past decade.
• Five-year net survival for all cancers has improved by 15 percent in the last 20 years - probably due to screening and advances in treatment.
• However, obesity rates, harmful alcohol consumption, poor nutrition and physical inactivity - which all increase risk of cancer - are either worse or no better than 20 years ago.
• Between 2018 and 2022, the rate for uterine cancer was over five times higher for Pacific females than for females of European ethnicity and almost twice as high for wāhine Māori.
• For breast cancer, wāhine Māori and Pacific females have a higher rate of diagnosis than females of European - rate of diagnosis among Pacific females, increasing by more than 50 percent between 2001 and 2022.

Prevention better than cure

Up to half of all cancers could be prevented by eradicating tobacco use, limiting alcohol intake and healthy nutrition, physical activity, sun protection and infection-prevention measures.

The report noted that people's risk of developing cancer often depended on where they lived, and their levels of power, money and resources, and "access to culturally safe care".

"For example, in many socioeconomically deprived areas - where more whānau Māori and Pacific families live - there is a higher density of fast-food and alcohol outlets, making healthy choices harder to access."

Cancer prevention was the most "cost-effective" approach to controlling some cancers.

"As the New Zealand population ages and increases in size, along with cancer incidence, 'treating our way out' of the significant increase that is forecast will not be possible," according to the report.

"Prevention must be prioritised - improved prevention efforts could see between approximately 8000 and 14,000 fewer cancer diagnoses each year."

Currently, only one in 10 adults eat the recommended amount of vegetables and just one in 17 eat the recommended amount of both fruit and vegetables.

For children, only one in 12 eat the recommended amount of vegetables, and daily breakfast consumption is declining.

Workplace exposures to carcinogens cause nearly one-third of work-related harm and roughly 650 deaths annually from cancer and respiratory diseases.

The New Zealand Carcinogens Survey, commissioned by WorkSafe New Zealand in 2021, found that 58 percent of workers were exposed to at least one carcinogen at work, with Māori, Pacific peoples and males facing higher exposure.

The next best thing to prevention: Early detection

Almost 1600 deaths per year could be avoided if all people diagnosed with late-stage bowel cancer were diagnosed at an early or mid-stage, when it could be treated more successfully.

About half of all European and Asian people with lung cancer were diagnosed following an emergency hospital admission.

For Māori, this proportion was far higher at 68 percent and for Pacific peoples higher still (73 percent).

Palliative care also needed critical attention and much better funding, particularly given predictions that, by 2038, the number of people needing palliative care would increase by more than 50 percent compared with 2015 levels, and by 90 percent by 2068.

Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.