Over the 30 years from 1985 to 2015, numbers of cancer-diagnoses in Australia increased about 2.5-fold and numbers of cancer-deaths increased about 1.7-fold. Corresponding increases for older Australians aged 75+ years were higher at about 3.1-fold for cancer-diagnoses and 2.6-fold for cancer-deaths. As a result, case loads have included progressively higher proportions of older people. This is illustrated by the increased percentage of cases in the 75+ age range which increased from 24% in 1985 to 30% in 2015 for cancer-diagnoses and from 33% to 52% for cancer deaths. These trends indicate the scale of increase in case load on cancer services over the past 30 years, which has been much greater among older than younger cases.
Little respite is anticipated. Compared with the percentage increase in population size projected in Australia over the next 30 years, a 51% higher percentage increase in cancer diagnoses and a 71% higher percentage increase in cancer deaths are projected, largely due change in age distribution. Cancer case complexity will increase with increased concentration of cancers in older Australians due to increased prevalence of age-related frailty and co-morbidity and age-related reductions in treatment effectiveness. Also due to ageing, a higher proportion of cases will experience a loss of living independence.
There will need to be an evidence-based response that includes stronger RCT evidence for treatment planning for older patients and broader health service data for monitoring clinical and health-system performance. Evidence-based planning and monitoring of limited resource availability will be paramount. The implications of increased cancer load on capacity of clinical services are significant and will need to be factored into health-service planning. For holistic care, community services including home support will need to be strengthened if as expected, more people with cancer and more facing death from cancer will be living alone.