More than 2.6 million Australians will be living with a cancer diagnosis in 2050, a jump of one million people over 25 years according to new modelling.

Population growth and an ageing population, and the rising incidence of some cancer types, will drive this projected increase, as well as improved cancer survival due to both early detection via screening and improved treatments.

It is the first time that researchers have projected the total number of Australians living with cancer – both those in active treatment plus those whose cancer is cured and who often have health needs arising from their treatment.

Lead author, Associate Professor Qingwei Luo from The Daffodil Centre, a research partnership between the University of Sydney and Cancer Council NSW, said the findings demonstrate that cancer is increasingly becoming a long-term condition rather than a short-term illness.

"More Australians are surviving cancer than ever before, which is a significant success story for cancer control, research and treatment improvement. However, as survival improves and the population grows and ages, more Australians will require ongoing support well beyond their initial diagnosis and treatment.”

Older Australians (aged more than 80 years) will see the biggest increase with the number projected to rise from 480,000 Australians in 2025 to over 1 million in 2050, up 111 percent.

The total number across all age groups is projected to rise 57 percent from 1.66 million in 2025 to 2.61 million in 2050.

The research, published today in the journal Lancet Regional Health Western Pacific, also projects that by 2050, breast cancer will be the nation’s most prevalent cancer, followed by prostate, melanoma, colorectal and kidney cancer.

The findings also highlight the growing impact of cancer among older Australians. By 2050, the number of survivors aged 80 and over is expected to more than double, and many of these will have complex needs, multiple chronic conditions, and long-term treatment effects.

Associate Professor Luo said the numbers also highlight opportunities to reduce the future cancer burden through continued investment in prevention and screening.

“Cancer prevalence is driven by both how many people are diagnosed and how long they live with or beyond cancer. These figures show cancer is not going away, but many diagnoses don’t have to happen. Preventing cancers from occurring in the first place is the most effective way to reduce the long-term burden on people and the health system.”

Joint senior author Professor Karen Canfell AC, who leads the Cancer Elimination Collaboration at the University of Sydney, said mapping long-term trends in cancer prevalence can inform current decisions on optimal cancer control policy.

“The prospect of 2.6 million individuals living with or after a cancer diagnosis is daunting, but there are opportunities to address the problem, now and over the longer term, through application of established evidence and prioritised research,” Professor Canfell said.

“Many of these cancers, including the most prevalent, can be prevented or detected early through organised screening or tailored approaches to identifying people at increased risk.

“One of the most challenging findings is that in 2050, around 1.15 million individuals will be in active treatment or closely monitoring a cancer that hasn’t been cured. If we can intervene early, through improved prevention, early detection, diagnosis and care pathways, that number would fall dramatically.

“One of the most prevalent cancers now and over the long term is breast cancer, so it’s timely that the Australian Government only last week launched a strategic framework for stratified screening, which has huge potential to find more cancers early and create a template for other cancers as evidence evolves.”

Professor Michael Jefford, joint senior author and Director of the Australian Cancer Survivorship Centre at the Peter MacCallum Cancer Centre, said the findings pointed to how the healthcare system needed to scale to meet future needs.

“There will be a huge increase in the number of survivors, many of whom have other illnesses,” says Professor Jefford, who is also a medical oncologist at Peter Mac and research lead with the Centre for Health Services Research in Cancer.

“We know that survivors have significant unmet needs and that existing models of care do not adequately manage these. Additionally, existing models are not sustainable, given the large numbers of survivors.

“Survivorship care should focus not just on surveillance for possible recurrence and second cancers but should also focus on the management of physical and psychosocial issues, health promotion and disease prevention, and management of chronic health conditions.”

The authors suggest managing the large numbers will require new models of care including care shared with, or led by, general practitioners, plus nurse-led models and remote monitoring. Of all people living with a cancer diagnosis in 2050, 44 percent are estimated to have a cancer that is not yet cured and requiring initial treatment or ongoing care while the majority will be in the post-treatment period.

Breast cancer survivor Naveena Nekkalapudi said: "Supportive care needs to be available before, during and after treatment to reduce toxicity and prevent avoidable long-term health complications”.

“This is about improving patient outcomes as well as making our health system more sustainable. Every dollar invested in supportive care has the potential to reduce the far greater costs of managing preventable conditions."

This research was a collaboration between researchers at the University of Sydney Cancer Elimination Collaboration, the Daffodil Centre, Cancer Council NSW and the Peter MacCallum Cancer Centre.

Research: Luo, Q. Long-term projections of cancer prevalence in Australia to 2050: a population-based statistical modelling study (Lancet Regional Health Western Pacific). DOI: 10.1016/S2468-2667(22)00090-1

Declaration

The study was assisted by direct funding and fellowships from NHMRC, Cancer Council NSW, and Cancer Institute NSW. The authors also thank the Australian Institute of Health and Welfare, National Drug Strategy Household Surveys, the Australian Data Archives and Services Australia and the Department of Health for the provision of data used in the study. Several authors declare competing interests. For a full list of financial declarations, please refer to the paper.