Cancer control in Australia: into the 21(st) Century.

Australia ranks highly internationally for cancer control, in part because cancer registries provide comprehensive national incidence and mortality and other cancer data annually. This has facilitated short- and long-term planning over the last quarter of a century. For example, male death rates from lung cancer in Australia peaked around 1985 and are now falling steeply, whereas female rates are still rising. In women, cervical cancer incidence and mortality have fallen owing to cervical screening over the last quarter of a century. Breast cancer mortality is now trending downwards after a half-century plateau, probably because of better treatment protocols. Cancer registry based State and national population treatment surveys over the last 15 years have identified both deficiencies and strengths in evidenced-based treatment of cancer in Australia. For example, in the State of Victoria, 5-yearly population based breast cancer treatment surveys have shown that the proportion of women who had a mastectomy versus a lumpectomy as their primary surgical operation fell from 78% in 1986 to 47% 1995. All Australians are covered by a universal health care system. Therefore, socio-economic status is not a barrier to accessing high quality cancer control, whether it be prevention, screening, treatment or education. In addition, non-government organizations (NGOs) specializing in cancer control have been providing free or highly subsidized support services to patients and their families for over half a century in most states. These NGOs have also been very active in public education about cancer, especially cancer prevention.