Cancer incidence: an overview

Since 1994, the most common cancer for men has been prostate cancer, with 73.5 cases per 100 000 (4 881 cases in absolute terms) in 2009. 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 cancer cases 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 slightly decreased compared to 2008 (in 2009: 4 955 cases or, age-standardised, 69.4 cases per 100 000). The age-standardised incidence rate of breast cancer decreased by 5% over the past ten years. The increased incidence of breast and prostate cancer in the past few years 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 key role in regional differences. Looking at the annual average between 2007 and 2009, Tyrol had the highest age-standardised rate (314.8 per 100 000 of population), followed by Carinthia (302.1) and Styria (298.3). The lowest age-standardised incidence rates were recorded in Salzburg and Vienna (238.9 and 251.3 new cases, respectively).

Between 2007 and 2009, prostate cancer – the most frequently diagnosed cancer in men – was most prevalent in the Länder (federal provinces) of Vorarlberg (105.8 new cases per 100 000 men), Carinthia (89.8) and Upper Austria (88.9). The lowest numbers of new cases were recorded in Vienna and Salzburg (62.3 and 64.7, respectively). Carinthia, Salzburg and Tyrol head the statistics for breast cancer, the most common cancer diagnosed in women (81.2, 80.2 and 78.3, respectively); Vienna and Lower Austria were least affected (61.1 and 67.6 per 100 000 women). The highest numbers of malignant colorectal neoplasm were recorded in Styria and Lower Austria (35.1 and 33.0 per 100 000 inhabitants); the lowest number was registered in Vienna (27.3).

The stage at diagnosis of cancer is an important factor in the prognosis of survival 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). 3 355 CIS cases have been registered in 2009; therefore the basic population for the following calculations combines the number of new cases in 2009 plus the number CIS-cases and amount to a total of 40 394 cases. Approximately one third of all cancers were diagnosed while the cancer was still limited to the particular organ (localised cancer stage: 32.5%). A fifth part of diagnoses were only made after the cancer had spread to other parts of the body (regional lymph node metastases, regionalised cancer stage: 18.9%). Distant metastases were registered in a further 10.4% of diagnoses (disseminated cancer stage). Systemic diseases cannot be assigned to any of these prognosis stages and accounted for 5.6% of all cancers. 24.4% of cancers could not be assigned to any stage of the disease, either because the cancer registration data was incomplete (16.4%) or because no information was available because they were DCO cases (8.0%). The remaining 8.3% represented carcinoma in situ cases.