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Cancer incidence: an overview

In 2007, 35 356 people were diagnosed with malignant neoplasms in Austria. There were considerably more incidence cases in 2006 (37 223 new cases) and 2% less than ten years ago (36 087 new cases). New cases in men decreased by 5% from 2006 to 2007, and an increase of 4% was recorded for the period from 1997 to 2007. For women, there was a decrease of 5% compared to 2006 and a 8% drop compared to 1997.

The long term trend shows a slightly increased risk of cancer for men until the year 2003 taking into account the change in age structure, now the values are below those of 1997. For women data show a slightly increased risk. In comparison to 1997 the age-standardised incidence rate decreased by 15% for men and also decreased for women (-15%). Viewed in the short term, there has been a considerable change in the risk of cancer for either sex. In 2007, the age-standardised cancer incidence rate in men decreased by 7% over the previous year, while also the rate for women decreased by 7%. Based on age-standardised rates, the risk of being diagnosed with cancer was 1.4 times higher for men than for women in 2007.

Looking at the time-trends of cancer incidences one should consider that the numbers for 2007 are of very high quality. However, the level of completeness is not yet as high as for the previous years.

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.

Table(s):
Cancer Incidence (incidences per years) by localization and sex, Austria since 1983XLS