Cancer incidence: an overview

Since 1994, the most common cancer for men has been prostate cancer, with 78.4 cases per 100 000 (4 986 cases in absolute terms) in 2007. Previously, the most frequently diagnosed cancer was lung cancer; the point in time at which it was overtaken by prostate cancer varies greatly from province to province. A particularly sharp decline can be seen in malignant neoplasms of the stomach, while other types of cancer show fairly small fluctuations. The increase in the annual number of new cases of cancer in men during the observation period can be attributed almost exclusively to the growing number of prostate cancers. The most common cancer site in women continues to be the breast, although the proportion of women diagnosed with breast cancer is comparable to 2006 (in 2006: 4 611 cases or, age-standardised, 66.4 cases per 100 000). The age-standardised rate of breast cancer incidence decreased by 14% over the past ten years. The increased incidence of breast and prostate cancer can be largely attributed to the increased number of preventive medical check-ups carried out (‘screening effect’).

Age-standardised rates are particularly suitable for regional comparison of new cases of cancer, as they eliminate varying population structures. Since, as already shown, the risk of being diagnosed with cancer is much higher for older people, the data needs to be adjusted for this effect before a regional comparison is carried out. Without this correction, more cases of cancer would be recorded from the outset in regions with an older population. Regional screening programmes and the reporting frequency of hospitals also play a role in regional differences. Looking at the annual average between 2005 and 2007, Carinthia had the highest age-standardised rate (322.4 per 100 000 of population), closely followed by Tyrol (316.0) and Burgenland (272.0). The lowest age-standardised incidence rates were recorded in Vorarlberg and Upper Austria (230.2 and 253.8 new cases, respectively).

In 2007, prostate cancer – the type of cancer most frequently diagnosed in men – was most prevalent in the Länder (federal provinces) of Carinthia (106.1 new cases per 100 000 men), Vorarlberg (104.6) and Tyrol (94.0). The lowest numbers of new cases were recorded in Vienna and Salzburg (70.9 and 76.0, respectively). Salzburg, Carinthia and Tyrol head the statistics for breast cancer, the most common cancer diagnosed in women (81.4, 78.6 and 75.3, respectively); Vorarlberg and Burgenland were least affected (63.4 and 64.8 per 100 000 women). The highest number of cases of malignant colorectal neoplasms were recorded for Lower Austria and Tyrol (both 37.4 new cases per 100 000 inhabitants), ahead of Styria (34.0) and Burgenland (33.6); the lowest number of malignant colorectal neoplasms was recorded in Vorarlberg (22.1).

The stage at diagnosis of cancer is an important factor in the prognosis of a cancer and is therefore recorded as far as possible for all cancer incidences. These results additionally include incidences of precancerous lesions, the so called Carcinoma in situ (CIS). 2 557 CIS cases have been registered in 2007; therefore the basic population for the following calculations combines the number of new cases in 2007 plus the number CIS-cases and amount to a total of 37 913 cases. Approximately a third of all cancers were diagnosed while the cancer was still limited to the particular organ (localised cancer stage: 31.7%). A sixth part of diagnoses were only made after the cancer had spread to other parts of the body (regional lymph node metastases, regionalised cancer stage: 17.5%). Distant metastases were discovered in a further 8.8% of diagnoses (disseminated cancer stage). Systemic diseases cannot be assigned to any of these prognosis stages and accounted for 5.4% of all cancers. 29.9% of cancers could not be assigned to any stage of the disease, either because the cancer registration data was incomplete (17.3%) or because no information was available about the stage of the disease in DCO cases (12.6%). The remaining 6.7% represented carcinoma in situ cases.