Oceania
Geographic dispersion, long distances, the impact of climate change, and a double burden of infection- and lifestyle-related cancers confront the nations of this vast region.
An estimated 181,000 new cancer diagnoses and 69,000 cancer deaths occurred in 2018 in the subregions of Oceania, namely Australasia, Melanesia, Micronesia, and Polynesia. (Figure 1) Cancers of the female breast (24,600 new cases, 14% of all cancers), prostate (23,500, 13%), and colorectum (22,300, 12%) are also commonly diagnosed in the region. Lung cancer accounts for the greatest number of cancer deaths (11,800, 17%), followed by colorectal (8,100, 12%) and female breast cancer (4,800, 7%). Skin cancers (melanoma and non-melanoma) are the most common cancers and represent a significant public health issue, particularly in Australia and New Zealand. (Figure 2)
Figure 1. Estimated number of new cancer cases vs. deaths and distribution (%) by type (excludes non-melanoma skin cancer) in Oceania, both sexes, 2018. There were an estimated 181,000 cancer cases. The leading cancer cases are breast (14%), prostate (13%), colorectum (12%), melanoma of skin (10%), lung (9%), non-Hodgkin lymphoma (4%), leukemia (3%), and other cancers (35%). There were an estimated 69,000 cancer deaths. The leading cancer deaths are lung (17%), colorectum (12%), breast (7%), prostate (7%), pancreas (6%), liver (5%), leukemia (4%), and other cancers (43%).
Figure 2. Incidence rates of melanoma of the skin in selected regions, both sexes combined, 2018. Age-standardized rate (world) per 100,000. In Australia and New Zealand, melanoma skin cancer incidence is 33.6. In Western Europe, melanoma skin cancer incidence is 18.8. In Northern Europe, melanoma skin cancer incidence is 17. In North America, melanoma skin cancer incidence is 12.6. In Southern Europe, melanoma skin cancer incidence is 9.1. In Central and Eastern Europe, melanoma skin cancer incidence is 5.3. In Polynesia, melanoma skin cancer incidence is 3.8. In Melanesia, melanoma skin cancer incidence is 3.2. In World, melanoma skin cancer incidence is 3.1. In South America, melanoma skin cancer incidence is 2.7. In Southern Africa, melanoma skin cancer incidence is 2.2. In Central America, melanoma skin cancer incidence is 1.9. In the world, melanoma skin cancer incidence is 3.1.
Given the relatively large proportion of the region’s inhabitants in Australia and New Zealand, the vast majority of the region’s cancer cases and deaths (93% and 85%, respectively) occur in these two countries. Papua New Guinea is unique among the other nations in terms of its relatively large population and burden (8.4 million, 11,200 new cases, 7,100 deaths); most of the Pacific Island countries and territories feature small populations that are often spread across many remote islands.
Delivering cancer services in our small island nations is a challenge. Regional solutions built collaboratively with local leaders have been shown to provide sustainable benefits.
Cancer profiles vary considerably across subregions. In Australasia and Polynesia, the cancers with the highest incidence rates include female breast, prostate, lung, and colorectum. (Figure 3a, b, c, d) In contrast, in Melanesia and Micronesia, breast cancer incidence rates are almost half those of the above regions, and cervical cancer is the second-leading cancer, with rates two to three times higher than the average rate in the region. (Map 1)
Figure 3a. Australia and New Zealand: Incidence and mortality rates in Oceania by sub-regions, top 10 cancers, 2018. Age-standardized rate (world) per 100,000. In Australia and New Zealand: Breast cancer incidence 94.2, mortality 12.6. Prostate cancer incidence 86.4, mortality 10.2. Colorectum cancer incidence 36.7, mortality 11.1. Melanoma of skin cancer incidence 33.6, mortality 3.4. Lung cancer incidence 26, mortality 17. Uterus cancer incidence 14.7, mortality 2.2. Non-Hodgkin lymphoma incidence 13.3, mortality 3. Thyroid cancer incidence 10.9, mortality 0.28. Leukemia incidence 9.9, mortality 3.5. Kidney cancer incidence 9.6, mortality 2.4.
Figure 3b. Polynesia: Incidence and mortality rates in Oceania by sub-regions, top 10 cancers, 2018. Age-standardized rate (world) per 100,000. In Polynesia: Breast cancer incidence 70.5, mortality 21.6. Prostate cancer incidence 66.5, mortality 19.9. Lung cancer incidence 38.1, mortality 30.2. Colorectum cancer incidence 16.2, mortality 4.4. Uterus cancer incidence 15.6, mortality 4.7. Thyroid cancer incidence 13.8, mortality 0.6. Cervix cancer incidence 10.7, mortality 5.2. Liver cancer incidence 9.2, mortality 7.4. Stomach cancer incidence 6.2, mortality 7.5. Non-Hodgkin lymphoma incidence 6.2, mortality 2.4.
Figure 3c. Melanesia: Incidence and mortality rates in Oceania by sub-regions, top 10 cancers, 2018. Age-standardized rate (world) per 100,000. In Melanesia: Breast cancer incidence 49.7, mortality 25.5. Prostate cancer incidence 34.1, mortality 14.5. Cervix cancer incidence 27.7, mortality 19. Lip, oral cavity cancer incidence 16.1, mortality 6.5. Colorectum cancer incidence 12.8, mortality 8.1. Lung cancer incidence 12.7, mortality 12.2. Liver cancer incidence 11.4, mortality 10.6. Uterus cancer incidence 11, mortality 3.1. Stomach cancer incidence 8.1, mortality 7.5. Thyroid cancer incidence 8.1, mortality 1.7.
Figure 3d. Micronesia: Incidence and mortality rates in Oceania by sub-regions, top 10 cancers, 2018. Age-standardized rate (world) per 100,000. In Micronesia: Breast cancer incidence 42.5, mortality 16.3. Prostate cancer incidence 42.4, mortality 16.3. Lung cancer incidence 37.9, mortality 35.5. Cervix cancer incidence 18.6, mortality 7.8. Colorectum cancer incidence 17.4, mortality 9.5. Liver cancer incidence 15.2, mortality 12. Uterus cancer incidence 14.3, mortality 1.4. Ovary cancer incidence 7.5, mortality 7.5. Thyroid cancer incidence 6.3, mortality 0.46. Stomach cancer incidence 5.7, mortality 3.
Australia HPV vaccine and cervical cancer screening coverage:
Hall MT, Simms KT, Lew J-B, et al. The projected timeframe until cervical cancer elimination in Australia: a modelling study. The Lancet Public Health. 2019;4: e19-e27.
Text:
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6): 394–424.
Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon, France: IARC. Available from: https://gco.iarc.fr/today.
Map and Figures 1–3:
Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon, France: IARC. Available from: https://gco.iarc.fr/today.