Aims
Cancer survivors experience poorer health and higher rates of non-cancer-related death than the general population. The adoption of novel cancer therapies is likely to influence long-term sequelae affecting cancer survivors. Limited data are available regarding clinical and sociodemographic characteristics and systemic therapy exposure of Australian cancer survivors, which are needed to inform health service planning.
Methods
We used a population-based data linkage for all adults residing in New South Wales (NSW) between 2005-2019. Using Cancer Registry and National Death Index data, we defined survivors as people aged ≥18 years who were alive during any part of each year and diagnosed with invasive cancer during or prior to that year. We counted the number of survivors in each year, overall and stratified by cancer type, age, and sex. Using Pharmaceutical Benefits Scheme data, we determined the number of survivors alive during each year with previous exposure to different classes of systemic therapy (chemotherapy, endocrine, targeted or immunotherapy).
Results
Cancer survivor numbers increased from 251,314 in 2005 to 446,392 in 2019. The most common cancers affecting survivors remained stable and in 2019 were: urogenital (24%), breast (19%), skin (16%) and bowel (11%). The fastest growing age group were survivors aged ≥70 years, who doubled from 120,036 to 240,236 between 2005-2019. The proportion of survivors alive ≥5 years after diagnosis increased from 63% in 2005 to 72% in 2019.
Survivors exposed to chemotherapy/endocrine therapy/targeted therapy increased from 24,378 (10% of survivors)/32,985 (13%)/292 (<1%) in 2005 to 97,607 (22%)/83,915 (19%)/25,785 (6%) in 2019. After immune checkpoint inhibitors became PBS-subsidised in 2013, survivors exposed to immunotherapy rose >200-fold from 98 (<1%) to 4,385 (1%) by 2019.
Conclusions
Adult cancer survivor numbers in NSW grew by 78% between 2005-2019, with rapid increase among older survivors, long-term survivors and survivors exposed to novel systemic cancer therapies.