DEVELOPMENTS in the HEALTH
SECTOR and CANCER
MOGA/PCPA Joint Scientific Meeting
Sydney - 13 August 2010
Professor Jim Bish...
Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)
7538
5004
4627
4210
4079 406...
AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010
SELF-ASSESSED PHYSICAL &
MENTAL HEALTH, 2007
Source: AIHW Australia’s Health 2010
BROAD CAUSE MORTALITY
TRENDS AUSTRALIA
Source: AIHW
All Cancer- Mortality/Incidence
ratios for selected countries - 2008
Source: IARC 2010.
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0....
Changes in Deaths rates in Males
using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW
Changes in Deaths Rates in
Females Using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW
BREAST CANCER
MORTALITY
NEJM 2005
Source: NEJM 2005
Cancers with reducing death
rates 1997 to 2006 – all ages
Lung, -18.5
Colon, -19.6 Prostate, -19.7
Leukaemia, -23.7
Stomac...
FIVE YEAR SURVIVAL
RATES - 2004
NSW SEER
Non small cell lung 13% 14%
Colon 65% 67%
Rectum 66% 69%
Breast Cancer 89% 90%
Ly...
Projected YLLs – Three scenarios,
Australia – 1980 to 2016
Source: Bishop et al – Cancer Institute NSW
PROJECTED BURDEN of
MAJOR DISEASE GROUPS, 2010
Source: AIHW Australia’s Health 2010
THE KEYS TO
PREVENTION
0.0 2.0 4.0 6.0 8.0
Tobacco
Blood pressure
Overweight/obesity
Physical inactivity
Blood cholesterol...
AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010
SMOKING IN
AUSTRALIA
SMOKING
STATUS
NSW VIC QLD WA SA TAS ACT NT AUS
Daily 16.4 16.5 17.2 14.8 16.5 22.7 14.7 25.3 16.6
We...
AUSTRALIA’S RECORD IN
TOBACCO CONTROL
 Advertising Bans
 Under the counter at retail sites
 Banning smoking in restaura...
OBESTITY INCREASING
FOR ALL
Source: AIHW: Australia’s Health 2008
Increased Risk Body Fatness Oesophagus
Pancreas
Colorectal
Breast (PM)
Endometrum
Abnormal Fatness Colorectal
Reduced Risk...
Total Cancer Cases and Deaths
per year (1972 to 2036)
Source: Cancer Institute NSW
NSW Cancer Deaths, Major
Cancer Types (2007-2036)
Source: Cancer Institute NSW
Milestones in
Cancer Control
 Public health measures in smoking reduction ,
screening breast, cervix, bowel, health liter...
PRIORITY HEALTH AREAS
SOURCE: NHMRC Research funding 2010 facts book
PRIORITY HEALTH AREAS
HEALTH REFORM
PROPOSED STRUCTURES
 National Health Performance Agency
 National Pricing Authority
 Expanded Australian ...
CURRENT INITIATIVES
in
CANCER CONTROL
 Australian health Survey
 Tobacco Control initiatives
 Cancer funding $2 billion...
 Four components run by ABS 2011- 2013
- Health Survey
- ATSI Health Survey
- Nutrition and Physical Activity
Survey
- He...
 Integrated Cancer Centre ($526m) – Camperdown
and Parkville
 Regional Cancer Centres ($560m) – 20 sites
announced
 Dig...
CLINICAL GUIDELINES
Supports for Clinical Decision Making
 Evidence Base
 Highest Impact
 Range of best practice tools
...
CLINICAL GUIDELINES
Highest Impact
 Greatest burden of disease
 Greatest harm from poor practice
 Greatest demonstrated...
 Cancer Control in Australia is successful by
international measures with more needed
 Research breakthroughs have deliv...
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Developments in the Health Sector and Cancer

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A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO,to MOGA/PCPA Joint Scientific Meeting in Sydney - 13 Aug 2010

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Developments in the Health Sector and Cancer

  1. 1. DEVELOPMENTS in the HEALTH SECTOR and CANCER MOGA/PCPA Joint Scientific Meeting Sydney - 13 August 2010 Professor Jim Bishop AO Chief Medical Officer Australian Government Department of Health and Ageing
  2. 2. Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP) 7538 5004 4627 4210 4079 4063 3970 3793 3737 3696 3677 3540 3470 3359 3353 3129 3060 3008 2902 2870 2729 2687 2683 2151 1801 1781 1737 1437 1213 999 852 767 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 1. Refers to insured population rather than resident population. 2. Current expenditure. 3. 2006. 4. 2007. Source: OECD, OECD Health Data, June 2010 Public expenditure on health Private expenditure on health OECD HEALTH DATA 2010 How Does AUSTRALIA Compare
  3. 3. AUSTRALIA’S RANKING AMONG OECD COUNTRIES 1987-2006 Source: AIHW Australia’s Health 2010
  4. 4. SELF-ASSESSED PHYSICAL & MENTAL HEALTH, 2007 Source: AIHW Australia’s Health 2010
  5. 5. BROAD CAUSE MORTALITY TRENDS AUSTRALIA Source: AIHW
  6. 6. All Cancer- Mortality/Incidence ratios for selected countries - 2008 Source: IARC 2010. 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Kenya Nigeria EgyptVietNam Turkey India China Russia South Africa G reece Brazil Japan Czech Republic Italy United Kingdom CanadaG erm anySweden New Zealand USAAustralia Mortality-to-incidenceratio Males Females
  7. 7. Changes in Deaths rates in Males using Joinpoint Analysis Source: Tracey et al – Cancer Institute NSW
  8. 8. Changes in Deaths Rates in Females Using Joinpoint Analysis Source: Tracey et al – Cancer Institute NSW
  9. 9. BREAST CANCER MORTALITY NEJM 2005 Source: NEJM 2005
  10. 10. Cancers with reducing death rates 1997 to 2006 – all ages Lung, -18.5 Colon, -19.6 Prostate, -19.7 Leukaemia, -23.7 Stomach, -29.4 Head and Neck, -23.7 Bladder, -18.5 Testicular, -42.2 Breast, -13.8 Cervix, -38.3 NHL, -25.1 Unknown, -24.8 Rectum , -19.9 Bowel , -19.7 All cancers, -13.8 , -24.3 -18.5 Kidney , -24.1 , -15.2 -31.9 , -21.1 -19.0 -19.0 , -18.9 -7.9 -45 -40 -35 -30 -25 -20 -15 -10 -5 0 Male Female Source: Tracey et al, Cancer Institute NSW
  11. 11. FIVE YEAR SURVIVAL RATES - 2004 NSW SEER Non small cell lung 13% 14% Colon 65% 67% Rectum 66% 69% Breast Cancer 89% 90% Lymphoma (DL) 53% 53% Source: Tracey et al – Cancer Institute NSW
  12. 12. Projected YLLs – Three scenarios, Australia – 1980 to 2016 Source: Bishop et al – Cancer Institute NSW
  13. 13. PROJECTED BURDEN of MAJOR DISEASE GROUPS, 2010 Source: AIHW Australia’s Health 2010
  14. 14. THE KEYS TO PREVENTION 0.0 2.0 4.0 6.0 8.0 Tobacco Blood pressure Overweight/obesity Physical inactivity Blood cholesterol Alcohol Fruit/vegetables Illicit drugs Air pollution Unsafe sex % DALYs Total of 32% Source: Table 4.1 AIHW Australia’s Health 2008
  15. 15. AUSTRALIA’S RANKING AMONG OECD COUNTRIES 1987-2006 Source: AIHW Australia’s Health 2010
  16. 16. SMOKING IN AUSTRALIA SMOKING STATUS NSW VIC QLD WA SA TAS ACT NT AUS Daily 16.4 16.5 17.2 14.8 16.5 22.7 14.7 25.3 16.6 Weekly 1.2 1.5 1.4 1.2 1.5 0.6 0.9 1.2 1.3 Less than Weekly 1.4 1.7 1.3 1.4 1.8 1.6 1.6 1.3 1.5 Ex-smoker 24.7 24.4 25.7 28.3 24.1 26.5 24.8 22.4 25.1 Never smoked 56.3 55.9 54.5 54.3 56.2 48.6 57.9 49.8 55.4 National Drug Strategy Household Survey 2007Source: 2007 Household Survey, Australian Government
  17. 17. AUSTRALIA’S RECORD IN TOBACCO CONTROL  Advertising Bans  Under the counter at retail sites  Banning smoking in restaurants, pubs and cars  Graphic warnings on cigarette packets  Anti-tobacco campaigns  Increase in tobacco excise  Plain packaging
  18. 18. OBESTITY INCREASING FOR ALL Source: AIHW: Australia’s Health 2008
  19. 19. Increased Risk Body Fatness Oesophagus Pancreas Colorectal Breast (PM) Endometrum Abnormal Fatness Colorectal Reduced Risk Physical exercise Colon SOURCE: World Cancer Research Fund: Food, nutrition, physical activity and prevention of cancer, 2007 OBESITY and CANCER
  20. 20. Total Cancer Cases and Deaths per year (1972 to 2036) Source: Cancer Institute NSW
  21. 21. NSW Cancer Deaths, Major Cancer Types (2007-2036) Source: Cancer Institute NSW
  22. 22. Milestones in Cancer Control  Public health measures in smoking reduction , screening breast, cervix, bowel, health literacy  Adjuvant treatment of breast, lung and bowel cancer  New anti-cancer drugs and symptom control drugs  Cancer research changing practice  Cancer registries, data linkage and analysis
  23. 23. PRIORITY HEALTH AREAS SOURCE: NHMRC Research funding 2010 facts book PRIORITY HEALTH AREAS
  24. 24. HEALTH REFORM PROPOSED STRUCTURES  National Health Performance Agency  National Pricing Authority  Expanded Australian Commission of Safety and Quality in Health Care (ACSQHC)  Preventative Health Agency
  25. 25. CURRENT INITIATIVES in CANCER CONTROL  Australian health Survey  Tobacco Control initiatives  Cancer funding $2 billion 09/10
  26. 26.  Four components run by ABS 2011- 2013 - Health Survey - ATSI Health Survey - Nutrition and Physical Activity Survey - Health measurement Survey  Around 50,000 participants  De-identified data available as summary statistics, tables AUSTRALIAN HEALTH SURVEY
  27. 27.  Integrated Cancer Centre ($526m) – Camperdown and Parkville  Regional Cancer Centres ($560m) – 20 sites announced  Digitalization of breast screening services  Access to new anti-cancer drugs ($613m)  Amalgamation Cancer Australia and NBOCC Programs CURRENT INITIATIVES IN CANCER CONTROL
  28. 28. CLINICAL GUIDELINES Supports for Clinical Decision Making  Evidence Base  Highest Impact  Range of best practice tools  Successful implementation methods  Monitor and report
  29. 29. CLINICAL GUIDELINES Highest Impact  Greatest burden of disease  Greatest harm from poor practice  Greatest demonstrated need: - New Standard of Care - Proven variation in practice  Greatest time spent/cost to health system
  30. 30.  Cancer Control in Australia is successful by international measures with more needed  Research breakthroughs have delivered population mortality reductions in Cancer  New research is needed in successful interventions for obesity, physical activity, diet and alcohol  Better methods of identifying susceptibility, early cancer and evidence-based interventions are urgently needed CONCLUSIONS

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