Chapter 29 The Burden

Cancer in Oceania

With excess body fatness rates exceeding 60–90%, small island nations in Oceania face a rising tide of cancer and other chronic diseases.

There are growing health challenges faced by many countries and territories in Oceania, with a rise in the burden of lifestyle-related diseases such as cancer exacerbated by the impact of climate change.

Annually, Oceania has an estimated 197,000 new cancer cases and 73,000 cancer deaths, excluding non-melanoma skin cancers. Cancer incidence rates vary more than threefold across countries, while mortality rates are less variable, with Samoa and French Polynesia ranking the highest, highlighting substantial disparities in early detection and treatment of cancers (Figure 29.1).

Despite having relatively lower cancer incidence rates, Samoa and French Polynesia experience the highest cancer mortality, highlighting disparities in early detection and treatment.

Figure 29.1

All cancers combined incidence and mortality (excluding non-melanoma skin cancer), age-standardized rates (world) per 100,000, by country in Oceania, 2022

Incidence
Mortality

In men, the most commonly diagnosed cancers are prostate cancer (23%), melanoma (12%), colorectal cancer (11%) and lung cancer (10%), while lung cancer is the leading cause of cancer death (18%), followed by prostate (14%) and colorectal (11%) cancers (Figure 29.2). In women, breast cancer (31%), colorectal cancer (11%) and lung cancer (8%) are the most frequent forms of cancer diagnosis, while breast cancer is the leading cause of cancer death (17%), followed by lung (16%) and colorectal (11%) cancers (Figure 29.2).

Figure 29.2

Estimated number of new cancer cases and deaths by type (excluding non-melanoma skin cancer) in Oceania, 2022

Breast
Prostate
Colorectum
Skin
Lung
Non-Hodgkin lymphoma
Prostate
Pancreas
Liver
Other specified cancers

The scale and profile of cancer in Oceania reflects the disproportionately large populations of Australia (60% of the total population), Papua New Guinea (22%), and New Zealand (11%), though marked differences in the cancer patterns are seen across the region. In men, lung cancer is the leading cause of cancer death in six out of 10 countries, and liver cancer in four countries (Fiji, Papua New Guinea, the Solomon Islands, and Vanuatu) (Map 29.1). In women, lung cancer is the leading cause of cancer death in Australia, New Zealand, Guam, and New Caledonia, while breast cancer dominates in the other islands, except Vanuatu, where cervical cancer ranks first (Map 29.1).

The region has demonstrated important cancer control successes, notably in Australia, with progress in tobacco control, cervical cancer screening and human papillomavirus vaccination, and ultraviolet radiation exposure prevention. Yet, these successes contrast with the growing challenges, worsened by the impacts of climate change, faced by many countries and territories on the continent. In particular, the Pacific Islands, geographically isolated, already suffer from health care systems that are overburdened by communicable diseases and are facing a rapid transition to lifestyle-related diseases, including cancer. Due to population aging and growth, cancer cases are expected to rise by 70% by 2050 in Oceania, with cancer deaths doubling, emphasizing the urgent need for effective, equitable cancer-control strategies.

Sources

  • Wade S, Weber MF, Sarich P, et al. Fifty-year forecasts of daily smoking prevalence: can Australia reach 5% by 2030? Tobacco Control. 2024;33(5):641. doi:10.1136/tc-2022-057624
  • Hall MT, Simms KT, Lew J-B, et al. The projected timeframe until cervical cancer elimination in Australia: a modelling study. The Lancet Public Health. 2019;4(1):e19-e27. doi:10.1016/S2468-2667(18)30183-X
  • Whiteman DC, Neale RE, Baade P, Olsen CM, Pandeya N. Changes in the incidence of melanoma in Australia, 2006-2021, by age group and ancestry: a modelling study. Med J Aust. Sep 2 2024;221(5):251-257. doi:10.5694/mja2.52404
  • Sarfati D, Dyer R, Sam FA, et al. Cancer control in the Pacific: big challenges facing small island states. Lancet Oncol. Sep 2019;20(9):e475-e492. doi:10.1016/s1470-2045(19)30400-0
  • Gordon-Strachan GM, Parker SY, Harewood HC, et al. The 2024 small island developing states report of the Lancet Countdown on health and climate change. Lancet Glob Health. Dec 4 2024;doi:10.1016/s2214-109x(24)00421-2

Maps

  • Map 29.1: Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2024). Global Cancer Observatory: Cancer Today (version 1.1). Lyon, France: International Agency for Research on Cancer. https://gco.iarc.who.int/today.

Figures

  • Figure 29.1-29.2: Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2024). Global Cancer Observatory: Cancer Today (version 1.1). Lyon, France: International Agency for Research on Cancer. https://gco.iarc.who.int/today.