Chapter 3: Cancer incidence in Canada: trends and projections (1983-2032) - HPCDP: Volume 35, Supplement 1, Spring 2015

Chapter 3: Overview of Observed and Projected Status of All Cancers

Recent changes in observed cancer incidence rates

The annual percent change in cancerspecific ASIRs in males and females in the last observed decade (1998–2007) shows varying trends by cancer site (Figures 3.1 and 3.2). Between 1998 and 2007, the overall incidence rate increased significantly in females by 0.3% per year. Statistically significant increases of 2% or more per year occurred for liver cancer in both males (3.6%) and females (2.4%), kidney cancer in males (2.6% since 2003) and thyroid in both males (6.8%) and females (6.9% since 2002). Significant annual decreases of 2% or more occurred in larynx cancer for both males (3.8%) and females (3.4%) and in stomach cancer in males (2.0%). The possible explanations for the observed trends can be found in the corresponding section of Chapter 4.

FIGURE 3.1
Annual percent changes in age-standardized incidence rates (1998–2007) for selected cancers, males, Canada

Annual percent changes in age-standardized incidence rates (1998–2007) for selected cancers, males, Canada

[Click to enlarge]

[FIGURE 3.1, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 3.1
Annual percent changes in age-standardized incidence rates (1998-2007) for selected cancers, males, Canada

The annual percent change in cancer-specific ASIRs in males in the last observed decade (1998-2007) shows varying trends by cancer site. Statistically significant increases of 2% or more per year occurred for liver cancer (3.6%), kidney cancer (2.6% since 2003) and thyroid (6.8%). Significant annual decreases of 2% or more occurred in larynx cancer (3.8%), and stomach cancer (2.0%).


Note: The error bars refer to 95% confidence intervals.

FIGURE 3.2
Annual percent changes in age-standardized incidence rates (1998–2007) for selected cancers, females, Canada

Annual percent changes in age-standardized incidence rates (1998–2007) for selected cancers, females, Canada

[Click to enlarge]

[FIGURE 3.2, Text Equivalent]

Promotion de la santé et prévention des maladies chroniques au Canada - Volume 35, numéro 1, mars 2015

FIGURE 3.2


Note: The error bars refer to 95% confidence intervals.

Overall (historic and projected) trends

Figure 3.3 illustrates the average annual number of new cases and ASIRs for all cancers combined for 1983–2032, with projections as of the year 2008. Even though the observed ASIRs for all cancers combined stabilized, the number of new cancer cases continues to increase as the Canadian population grows and ages. The ASIRs in males decreased after increasing until 1993–1997. This pattern mirrors a similar trend in the incidence of prostate cancer, the leading cancer in males. The decrease also represents the decrease in lung cancer rates in men aged 65 or older. In females, the cancer incidence rate increased slightly over the observation horizon. The increase reflects the rise in rates in cancers of lung (in women aged 65 or older), uterus, thyroid, breast (in females aged under 45), leukemia, kidney, and melanoma.

FIGURE 3.3
Average annual new cases and age-standardized incidence rates (ASIRs) for all cancers, Canada, 1983–2032

Average annual new cases and age-standardized incidence rates (ASIRs) for all cancers, Canada, 1983–2032

[Click to enlarge]

[FIGURE 3.3, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 3.3
Average annual new cases and age-standardized incidence rates (ASIRs) for all cancers, Canada, 1983-2032

Figure 3.3 illustrates the average annual number of new cases and ASIRs for all cancers combined for 1983-2032, with projections as of the year 2008. Even though the ASIRs have and will continue to stabilize, the number of new cancer cases continues to increase as the Canadian population grows and ages. The observed ASIRs in males decreased after increasing until 1993-1997. This pattern mirrors a similar trend in the incidence of prostate cancer, the leading cancer in males. The decrease also represents the decrease in lung cancer rates in men aged 65 or older. In females, the cancer incidence rate increased slightly over the observation horizon. The increase reflects the rise in rates in cancers of lung (in women aged 65 or older), uterus, thyroid, breast (in females aged under 45), leukemia, kidney, and melanoma.

All cancers combined excludes non-melanoma skin cancer. In Canada, non-melanoma skin cancer accounts for about 30% of all new cancer cases.

Tables 3.1 to 3.4 show historic and projected numbers of new cancer cases and ASIRs by sex, period, age group and geographical region. From 2003–2007 to 2028–2032, the ASIRs for all cancers in Canada are projected to decrease in males by 5%, from 464.8 to 443.2 per 100 000, and to increase in females by 4%, from 358.3 to 371.0 per 100 000. The annual number of cases is projected to increase by 84% (from 80 810 to 148 370) in males and by 74% (from 74 165 to 128 830) in females.

TABLE 3.1
Observed (2003–2007) and projected average annual new cases by age and province/territories combined (TC), all cancers, males, Canada, 2003–2032
Period Age New cases
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Note: Totals may not add up due to rounding.

2003–07 <45 4720 560 495 125 155 1950 1080 100 155 20 65 15
45–54 8265 970 850 230 280 3230 2000 225 285 40 140 20
55–64 18 860 2280 1655 540 600 7145 4870 545 715 110 360 40
65–74 24 570 3090 2090 840 825 9375 6135 710 905 140 420 40
75–84 19 040 2600 1555 705 725 6985 4925 500 670 95 260 20
85+ 5350 785 440 235 240 1750 1470 155 195 30 55 5
Total 80 810 10 280 7090 2675 2825 30 430 20 480 2235 2925 440 1295 140
2008–12 <45 4810 555 555 125 135 1940 1060 100 140 20 65 10
45–54 9490 1015 1015 255 280 3865 2180 235 320 50 140 25
55–64 23 235 2665 2120 695 680 9090 5640 710 875 135 455 55
65–74 27 390 3435 2160 870 830 10 455 6875 850 1060 160 495 50
75–84 20 520 2775 1680 675 660 7435 5520 545 705 110 275 25
85+ 7065 1050 560 245 265 2385 2055 180 220 30 55 5
Total 92 515 11 495 8085 2860 2850 35 170 23 330 2620 3320 510 1490 170
2013–17 <45 5085 590 590 120 130 2030 1110 100 140 20 65 10
45–54 9505 1000 1035 245 260 3965 2085 230 315 50 145 25
55–64 26 330 2985 2610 795 750 10 455 6140 760 910 150 470 60
65–74 33 695 4245 2810 1005 990 12 860 8175 1070 1320 200 630 75
75–84 22 080 2955 1855 680 660 7910 5935 620 780 125 310 35
85+ 8940 1265 750 265 295 3080 2670 205 250 35 65 5
Total 105 630 13 040 9645 3115 3085 40 300 26 115 2985 3715 580 1685 210
2018–22 <45 5420 650 605 125 130 2170 1155 105 145 20 70 10
45–54 8895 925 1015 220 235 3735 1890 215 280 45 130 20
55–64 28 975 3235 2945 845 800 11 885 6500 780 970 170 465 65
65–74 40 245 5110 3665 1220 1165 15 510 9295 1250 1505 235 735 95
75–84 25 830 3445 2220 740 750 9150 6925 760 950 145 385 50
85+ 10 370 1450 915 285 305 3530 3155 240 280 45 80 10
Total 119 730 14 810 11 360 3440 3385 45 985 28 915 3355 4130 655 1870 250
2023–27 <45 5765 710 620 130 130 2340 1190 110 150 20 70 10
45–54 9065 950 1065 215 240 3785 1940 215 275 40 125 20
55–64 28 925 3245 2970 815 775 12 195 6210 750 950 170 460 60
65–74 46 165 5815 4515 1415 1325 18 160 10 280 1350 1615 260 770 110
75–84 32 640 4395 2960 895 945 11 625 8475 975 1220 180 505 70
85+ 11 725 1615 1055 305 335 3995 3570 280 330 50 95 10
Total 134 285 16 725 13 185 3780 3750 52 105 31 670 3685 4545 725 2025 280
2028–32 <45 5990 745 620 135 125 2475 1220 115 150 15 70 10
45–54 9780 1070 1135 235 260 4065 2060 215 295 45 135 15
55–64 27 300 3075 2930 750 715 11 615 5685 700 860 150 420 55
65–74 51 070 6370 5090 1510 1440 20 765 10 950 1405 1745 295 780 115
75–84 39 720 5365 3930 1115 1140 14 280 9880 1155 1415 215 600 90
85+ 14 510 2010 1335 350 400 4855 4475 365 425 65 130 15
Total 148 370 18 635 15 040 4090 4085 58 055 34 275 3955 4890 785 2140 305
TABLE 3.2
Observed (2003–2007) and projected average annual new cases by age and province/territories combined (TC), all cancers, females, Canada, 2003–2032
Period Age New cases
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Note: Totals may not add up due to rounding.

2003–07 <45 7940 895 820 190 240 3505 1725 175 230 30 110 20
45–54 11 490 1370 1095 310 395 4490 2950 280 345 45 185 30
55–64 15 485 1870 1305 440 550 5810 4195 400 530 75 275 35
65–74 16 325 2025 1350 515 570 6245 4280 405 570 85 250 25
75–84 15 975 2035 1225 550 655 5960 4280 420 565 75 200 15
85+ 6945 900 540 280 310 2380 1990 190 265 35 55 5
Total 74 165 9100 6335 2280 2715 28 385 19 425 1870 2505 345 1075 130
2008–12 <45 7900 850 875 185 235 3605 1630 165 195 25 105 20
45–54 12 670 1430 1245 325 400 5195 3125 290 370 50 205 30
55–64 18 805 2235 1690 520 645 7140 5030 480 595 85 335 45
65–74 18 915 2315 1600 565 655 7135 5075 485 640 95 330 35
75–84 16 755 2025 1390 545 630 6310 4635 420 575 80 215 20
85+ 8885 1185 730 315 375 3170 2530 225 305 40 65 5
Total 83 930 10 040 7525 2460 2945 32 560 22 020 2070 2675 375 1255 160
2013–17 <45 8280 860 935 200 255 3865 1670 170 190 30 100 20
45–54 12 770 1425 1290 290 385 5595 2910 275 340 45 195 30
55–64 21 300 2425 2045 600 720 8270 5560 515 635 90 370 55
65–74 23 685 2870 2075 660 795 8915 6405 625 785 115 445 50
75–84 17 955 2150 1575 560 650 6745 4965 460 610 90 255 30
85+ 10 500 1310 915 355 420 3770 3125 260 345 50 85 5
Total 94 495 11 035 8830 2660 3220 37 160 24 635 2305 2900 420 1450 195
2018–22 <45 8685 905 995 210 280 4130 1715 165 180 30 100 15
45–54 12 365 1370 1275 260 360 5685 2610 260 300 40 175 30
55–64 23 405 2590 2300 635 760 9510 5820 550 675 95 380 60
65–74 28 330 3400 2640 790 940 10 780 7505 735 900 130 535 70
75–84 21 170 2545 1915 620 735 7820 5945 550 720 110 340 45
85+ 11 635 1415 1075 365 450 4190 3530 280 360 55 100 10
Total 105 590 12 230 10 200 2875 3525 42 110 27 125 2545 3140 465 1630 235
2023–27 <45 9035 975 1025 220 295 4425 1695 165 175 30 100 15
45–54 12 750 1380 1340 280 375 5890 2665 265 305 45 160 30
55–64 23 410 2625 2350 570 735 10 080 5360 525 635 90 360 60
65–74 32 100 3775 3165 915 1050 12 430 8270 800 985 145 585 90
75–84 26 800 3245 2495 740 905 9860 7535 715 910 135 455 65
85+ 13 085 1600 1270 400 480 4675 3975 320 405 70 120 15
Total 117 185 13 600 11 645 3125 3845 47 365 29 500 2790 3415 515 1780 280
2028–32 <45 9110 995 1020 215 295 4580 1655 175 175 30 105 15
45–54 13 610 1505 1475 310 435 6340 2785 250 295 45 150 25
55–64 22 685 2560 2310 520 695 10 190 4825 500 570 80 325 60
65–74 35 275 4085 3550 970 1115 14 235 8655 855 1065 155 605 100
75–84 32 250 3900 3180 900 1080 11 955 8875 845 1065 160 550 95
85+ 15 895 1950 1570 445 555 5590 4925 390 500 85 170 25
Total 128 830 14 995 13 105 3360 4170 52 890 31 720 3015 3670 555 1900 320
TABLE 3.3
Observed (2003–2007) and projected age-standardized incidence rates (ASIRs) by age and povince/territories combined (TC), all cancers, males, Canada, 2003–2032
Period Age ASIRs
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

2003–07 <45 46.0 43.1 43.4 42.8 42.4 48.3 45.6 44.4 54.1 53.3 40.8 35.0
45–54 331.4 291.0 330.1 307.3 316.8 346.2 327.3 368.3 381.3 393.1 319.7 259.3
55–64 1109.9 975.6 1099.4 1132.0 1019.7 1133.7 1120.4 1239.1 1295.8 1369.8 1124.0 932.9
65–74 2287.3 2035.9 2305.9 2453.0 2218.9 2302.8 2297.5 2672.0 2642.8 2782.8 2238.1 2446.9
75–84 3068.1 2876.7 3046.6 3012.9 2999.1 2907.7 3404.9 3358.1 3583.7 3517.4 2724.6 3229.8
85+ 3506.6 3246.0 3394.8 3122.3 3355.0 3093.5 4643.9 3735.2 3631.1 3692.9 2367.1 2467.3
Total 464.8 420.2 461.3 467.3 444.3 461.1 489.3 517.7 535.7 550.6 433.8 440.2
2008–12 <45 47.7 42.4 45.1 42.4 37.9 49.3 46.6 47.6 54.9 49.3 47.5 31.2
45–54 342.9 279.5 340.0 321.4 295.3 362.0 331.4 380.8 405.2 434.7 330.5 281.2
55–64 1129.3 929.0 1062.6 1165.2 959.9 1190.9 1113.7 1341.0 1347.4 1419.7 1191.9 928.6
65–74 2208.8 1946.8 2055.6 2394.1 2001.2 2254.4 2185.5 2666.1 2652.8 2729.1 2216.4 2327.6
75–84 2942.7 2714.5 2860.4 2867.5 2672.3 2767.8 3280.2 3371.6 3424.2 3519.0 2613.7 3340.0
85+ 3368.6 3176.5 3220.2 2878.2 2999.6 2950.5 4469.9 3416.4 3477.7 3603.6 2139.2 3120.6
Total 457.6 401.9 434.8 459.7 403.5 458.7 476.0 526.9 536.7 552.1 437.7 442.0
2013–17 <45 49.3 43.1 45.7 41.0 35.0 50.4 48.0 50.8 56.9 48.0 51.4 30.3
45–54 341.9 268.5 344.9 330.3 282.8 357.2 328.3 386.7 413.8 441.6 348.7 292.8
55–64 1120.4 919.8 1076.3 1150.2 915.9 1183.3 1085.6 1340.3 1296.4 1458.8 1186.2 893.9
65–74 2157.2 1898.1 2018.9 2309.2 1895.1 2203.5 2104.0 2607.6 2617.2 2651.4 2200.5 2186.3
75–84 2867.6 2608.8 2824.4 2879.8 2587.1 2684.2 3159.4 3320.8 3332.2 3382.3 2515.8 3452.5
85+ 3345.1 3061.9 3272.9 2824.4 2935.6 2902.9 4447.3 3397.1 3467.1 3615.1 2135.7 3071.7
Total 451.4 392.1 433.7 452.5 385.4 451.3 464.1 523.7 528.8 545.3 437.3 433.5
2018–22 <45 50.5 44.6 45.4 40.6 33.3 51.5 48.5 52.0 59.0 46.4 56.1 27.4
45–54 346.3 260.4 350.8 330.7 273.4 361.9 334.4 409.4 422.5 421.0 361.5 301.1
55–64 1114.2 907.9 1083.8 1145.1 900.8 1176.9 1068.0 1332.7 1297.5 1502.9 1168.9 884.7
65–74 2130.2 1870.0 2026.7 2258.2 1822.8 2190.7 2046.5 2573.5 2538.7 2609.4 2173.6 2126.1
75–84 2782.1 2532.5 2759.1 2829.2 2486.9 2600.1 3020.4 3228.1 3286.9 3286.9 2500.3 3213.3
85+ 3277.6 2968.9 3268.1 2849.4 2826.1 2810.4 4351.1 3422.5 3345.9 3625.9 2135.2 3445.8
Total 446.6 385.6 432.9 446.8 372.3 447.2 453.7 520.9 523.1 539.6 438.0 422.8
2023–27 <45 51.8 46.0 45.7 41.4 31.7 52.7 49.7 54.2 59.3 43.5 58.9 27.8
45–54 354.3 264.7 354.7 315.8 273.9 373.8 340.6 423.8 445.9 424.3 380.5 275.7
55–64 1112.2 889.6 1094.3 1169.0 893.6 1173.6 1061.8 1338.3 1322.3 1510.5 1204.6 902.2
65–74 2115.6 1862.3 2045.3 2238.9 1788.2 2190.6 2000.2 2559.6 2468.9 2653.8 2143.9 2033.8
75–84 2715.7 2477.3 2707.2 2724.7 2401.9 2556.1 2910.6 3132.1 3252.1 3133.1 2448.2 3025.3
85+ 3183.1 2848.0 3199.1 2872.0 2823.0 2745.5 4177.2 3286.2 3284.9 3337.1 1982.1 3329.5
Total 443.8 381.8 433.2 443.0 365.2 446.8 445.9 518.7 521.3 533.2 439.6 407.6
2028–32 <45 52.8 46.8 45.8 42.0 29.9 53.8 51.0 55.6 57.2 36.2 59.7 28.1
45–54 361.1 276.1 352.9 313.4 278.1 381.6 339.2 427.6 476.5 443.8 427.6 242.0
55–64 1121.5 873.7 1106.0 1173.9 882.6 1186.9 1074.8 1383.0 1343.2 1459.9 1230.4 909.2
65–74 2106.3 1845.6 2060.8 2239.0 1779.0 2184.7 1973.7 2541.9 2485.4 2730.1 2122.2 2018.7
75–84 2682.2 2449.9 2725.4 2670.3 2326.4 2548.3 2832.4 3087.4 3143.8 3089.7 2426.8 2927.3
85+ 3086.7 2794.6 3120.2 2776.5 2689.4 2651.1 4018.4 3189.2 3258.1 3340.9 2043.7 2983.8
Total 443.2 379.5 434.9 440.6 358.8 447.9 441.4 520.1 521.9 529.5 445.8 396.8
TABLE 3.4
Observed (2003–2007) and projected age-standardized incidence rates (ASIRs) by age and province/territories combined (TC), all cancers, females, Canada, 2003–2032
Period Age ASIRs
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

2003–07 <45 77.6 67.3 76.0 65.9 68.9 86.2 73.4 74.7 77.5 68.5 67.6 60.3
45–54 459.8 405.1 442.7 424.9 456.7 477.2 479.8 454.7 454.1 423.5 416.5 435.8
55–64 875.8 779.9 865.6 901.5 908.0 876.9 914.4 886.4 923.9 902.5 848.4 1003.9
65–74 1372.1 1283.4 1396.0 1386.5 1363.1 1362.6 1405.8 1391.2 1515.1 1583.5 1277.7 1680.4
75–84 1828.8 1737.8 1805.9 1757.9 1867.6 1758.8 1971.2 1907.9 2085.6 1956.8 1569.3 2078.9
85+ 2023.8 1869.5 1978.6 1772.8 1919.8 1894.5 2453.6 1982.7 2097.8 1973.2 1081.8 1834.0
Total 358.3 326.1 354.8 344.6 354.4 361.7 372.7 360.4 381.4 368.9 319.0 382.9
2008–12 <45 79.4 64.2 77.6 67.1 69.6 90.6 74.0 79.3 72.9 71.3 71.2 57.1
45–54 465.1 389.1 445.4 415.8 432.8 493.0 484.2 454.3 459.2 407.4 459.5 414.1
55–64 880.0 747.8 864.4 869.6 888.1 889.5 947.0 877.0 878.7 830.8 848.1 886.4
65–74 1397.4 1250.5 1437.2 1447.9 1444.3 1384.0 1458.9 1445.6 1470.6 1530.6 1408.4 1718.1
75–84 1838.1 1668.4 1892.9 1812.9 1899.0 1781.7 2000.7 1920.2 2079.2 1980.7 1605.8 2509.1
85+ 2042.4 1937.0 2094.1 1856.0 1992.9 1924.8 2419.9 1990.6 2126.3 1846.7 1145.8 1890.5
Total 362.7 315.5 363.2 348.7 358.0 370.2 380.7 367.0 372.0 358.9 337.0 386.7
2013–17 <45 81.1 62.3 78.4 69.9 71.6 94.5 74.9 83.0 72.4 75.3 74.9 54.4
45–54 476.5 387.4 464.0 397.7 428.8 521.5 482.0 461.4 447.9 392.3 458.6 404.5
55–64 875.1 711.8 860.9 857.5 879.2 896.0 947.3 863.2 848.7 819.6 880.9 892.3
65–74 1402.8 1217.3 1431.1 1435.6 1423.2 1395.4 1500.4 1446.6 1431.8 1396.2 1450.0 1556.5
75–84 1862.5 1650.6 1965.0 1903.5 1963.8 1800.5 2045.9 1963.9 2042.2 2056.7 1712.4 2623.6
85+ 2059.0 1845.4 2165.1 1944.2 2011.0 1933.9 2480.6 2062.5 2253.8 1990.6 1264.3 2115.6
Total 366.1 307.0 368.4 351.0 359.3 378.0 386.2 371.4 365.2 354.0 350.2 379.7
2018–22 <45 80.9 61.2 79.4 70.7 74.3 95.9 73.0 81.5 69.4 73.9 76.7 50.4
45–54 494.7 386.2 473.2 401.4 431.9 557.2 489.0 496.7 451.8 411.0 462.2 412.6
55–64 883.4 701.1 866.3 850.7 865.4 919.4 947.2 888.2 850.5 791.0 899.4 875.5
65–74 1387.1 1168.3 1409.8 1396.5 1386.3 1390.1 1512.8 1401.1 1388.5 1340.6 1447.6 1564.1
75–84 1881.5 1640.5 2005.3 1960.3 1982.8 1810.6 2087.7 1984.7 2025.1 2089.3 1827.0 2560.5
85+ 2061.9 1821.2 2209.9 1961.0 2090.4 1938.0 2500.3 2084.3 2196.0 1982.0 1337.4 2302.1
Total 368.3 301.3 370.9 350.8 359.3 384.9 388.2 374.2 359.4 349.9 358.0 376.5
2023–27 <45 80.5 61.5 78.7 71.2 74.5 96.9 71.1 82.8 64.9 73.3 80.4 49.2
45–54 503.5 379.6 478.4 419.1 442.0 573.2 491.3 514.4 478.8 448.5 459.7 411.6
55–64 897.5 708.1 889.7 817.0 854.4 957.5 934.6 896.3 846.0 780.0 880.7 890.9
65–74 1376.2 1134.0 1394.3 1381.2 1371.9 1392.5 1501.1 1383.3 1365.3 1332.4 1472.4 1618.6
75–84 1878.9 1616.7 1979.2 1938.3 1946.1 1812.1 2126.5 1977.2 1997.4 1923.5 1831.2 2407.2
85+ 2092.4 1833.8 2294.3 2104.9 2144.1 1950.6 2550.1 2135.5 2204.3 2148.6 1405.5 2445.5
Total 369.7 298.3 371.9 349.8 357.8 391.0 387.1 376.8 356.4 347.8 361.2 376.6
2028–32 <45 79.3 60.6 78.3 69.7 71.4 96.4 69.3 86.6 64.9 72.6 84.4 48.0
45–54 504.3 382.7 485.0 429.0 478.0 582.6 477.6 485.1 451.0 444.3 452.0 390.9
55–64 924.9 712.0 903.0 820.6 859.0 1011.6 940.4 950.5 855.6 814.0 876.3 921.1
65–74 1385.3 1127.1 1399.5 1365.6 1345.9 1421.1 1493.7 1415.0 1380.4 1308.4 1483.6 1620.8
75–84 1852.7 1562.0 1946.5 1884.9 1896.6 1797.0 2129.0 1906.7 1951.7 1895.8 1819.4 2483.2
85+ 2099.2 1825.4 2300.0 2107.2 2136.8 1948.8 2582.1 2131.0 2190.7 2121.5 1498.1 2307.0
Total 371.0 295.8 372.7 347.2 356.3 397.6 384.8 380.5 353.5 346.9 364.1 377.6

Figure 3.4, presenting the determinants of increases in the total average annual numbers of cancer incidence cases (see Chapter 2 for definitions of the series), shows that the observed and projected increase in the number of cancer cases mainly results from the aging of the population and, to a lesser extent, population growth. Changes in the risk of cancer have been contributing marginally to the increase in new cases, especially in males. In 2028–2032, the percentages of the total changes due to aging, population increase and cancer risk are predicted to be 70.9%, 29.1% and 0.1% respectively in males, and 58.4%, 35.5% and 6.1% in females. In addition, the percentages of the total changes due to change of age distribution increase with time, from 41.5% in 1988– 1992 to 70.9% in 2028–2032 in males and from 42.0% to 58.4% in females. The percentages due to change of population size generally decrease over the same period, from 39.8% to 29.1% in males and from 46.8% to 35.5% in females. The percentages due to change of cancer risk decrease in males from 18.7% to 0.1% over the study period, whereas the percentages in females increased from 11.2% in 1988–1992 to 14.1% in 1998–2002 (in part because of increased mammography screening) and decrease thereafter to 6.1% in 2028–2032.

FIGURE 3.4
Trends in average annual new cases for all cancers and ages, attributed to changes in cancer risk, population growth, and aging population, Canada, 1983–2032

Trends in average annual new cases for all cancers and ages, attributed to changes in cancer risk,
                                population growth, and aging population, Canada, 1983–2032

[Click to enlarge]

[FIGURE 3.4, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 3.4
Trends in average annual new cases for all cancers and ages, attributed to cancer risk, population growth, and aging population, Canada, 1983-2032

Figure 3.4, presenting the determinants of increases in the total average annual numbers of cancer incidence cases, shows that the observed and projected increase in the number of cancer cases mainly results from the aging of the population and, to a lesser extent, the population growth. Changes in the risk of cancer will constitute a relatively small component of the projected increase in new cases among females, and will cause a relatively small decrease in new cases among males, although the total male cases will increase.

Trends by age

Figure 3.5 shows similar patterns of cancer occurrence and population distribution in males and females. The figure shows the increase in percentage of the population at older ages along with the corresponding increase in the number of expected cancer cases. Cancer cases increase with age until the peak in the 70–74 age group in both sexes, and illustrate approximately bell shaped symmetric distributions about the peak in the 50-or-older age groups.

FIGURE 3.5
Historic and projectedFigure 3.5 - Footnote a growth in average annual population (pop) and in average annual incidence cases of all cancers in Canada by age, 1983–2032

Historic and projected growth in average annual population (pop) and in average annual
                                incidence cases of all cancers in Canada by age, 1983–2032

[Click to enlarge]

[FIGURE 3.5, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 3.5
Historic and projected growth in average annual population (pop) and in average annual incidence cases of all cancers in Canada by age, 1983-2032

Figure 3.5 shows similar patterns of cancer occurrence and population distribution in males and females. Cancer cases increase with age until the peak in the 70-74 age group in both sexes, and illustrate approximately bell-shaped symmetric distributions about the peak in the 50-or-older age groups.

The figure shows the increase in percentage of the population at older ages along with the corresponding increase in the number of expected cancer cases. Even though incidence rates are projected to increase for females, and decrease for males, because the growth in population in males age 65 or older is expected to be greater than that in females, the projected number of cases will go up faster for males than for females.


aCases and populations in the 2028–2032 period are projected.

Trends by sex

Figure 3.6 compares the ASIRs for all cancers between sexes by 10-year age group from 1983 to 2032. Cancer is more common in males than in females except in those aged under 55. Breast cancer is the most common cancer in females under 55, accounting for 30% to 40% of cases in this age range in 2003–2007 (see Figure 3.9). Thyroid and cervical cancer also account for the higher cancer incidence in younger females. The overall cancer incidence rate in men aged 65 or older has been falling. The decrease in lung cancer incidence rates in males aged 65 or older as a result of decrease in tobacco useEndnote 36, Endnote 42, Endnote 43 and the decrease in prostate cancer rates in people aged 75 or older have together contributed to the overall decrease in this age range, as these two cancers account for 42% of all new cancer cases in Canadian men in 2003–2007. In women aged 65 or older, the relatively stable rate is the result of an increase primarily of lung cancer incidence offset by decreases in incidence for the other cancer sites.

FIGURE 3.6
Age-standardized incidence rates (ASIRs) for all cancers by age group, Canada, 1983–2032 (red lines denote males, blue lines denote females)

Age-standardized incidence rates (ASIRs) for all cancers by age group (males, females), Canada, 1983–2032

[Click to enlarge]

[FIGURE 3.6, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 3.6
Age-standardized incidence rates (ASIRs) for all cancers by age group, Canada, 1983-2032

Figure 3.6 compares the ASIRs for all cancers between sexes by 10-year age group from 1983 to 2032. Cancer is more common in males than in females except in those aged under 55. The overall cancer incidence rate in men aged 65 or older has been falling. In women aged 65 or older, the relatively stable rate is the result of an increase primarily of lung cancer incidence offset by decreases in incidence for the other cancer sites.

Trends by geographical region

Figure 3.7 shows historic and estimated ASIRs for all cancers combined by sex and region from 1983 to 2032. In males, the ASIRs for all cancers combined are projected to continue to be highest in the Atlantic region and lowest in British Columbia. Male incidence rates in Quebec, Ontario, the Prairies and British Columbia are projected to decrease and then stabilize, while rates in the Atlantic region will be relatively stable. In females, Ontario is predicted to surpass Quebec and experience the highest rates in 15 years (i.e. after 2018–2022), while British Columbia will continue to have the lowest incidence. Female incidence rates are predicted to increase 10%, 3% and 1% in Ontario, Quebec and the Atlantic region, respectively, and decrease 9% and 7% in British Columbia and the Prairies by 2028–2032. This follows an increasing trend in the former regions prior to 2008 and a decreasing trend in the latter regions starting in 1998–2002. The overall differences in cancer incidence across the country are smaller in females, ranging from 7.1 to 101.8 per 100 000 versus 45.9 to 134.6 per 100 000 in males over the observation and projection periods.

FIGURE 3.7
Age-Standardized Incidence Rates (ASIRs) by region, all cancers, 1983–2032

Age-Standardized Incidence Rates (ASIRs) by region, all cancers, 1983–2032

[Click to enlarge]

[FIGURE 3.7, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 3.7
Age-Standardized Incidence Rates (ASIRs) by region, all cancers, 1983-2032

Figure 3.7 shows historic and estimated ASIRs for all cancers combined by sex and region from 1983 to 2032, with projections as of the year 2008. In males, the ASIRs are projected to continue to be highest in the Atlantic region and lowest in British Columbia. Male incidence rates in Quebec, Ontario, the Prairies and British Columbia are projected to decrease and then stabilize, while rates in the Atlantic region will be relatively stable. In females, Ontario is predicted to surpass Quebec and experience the highest rates in 15 years, while British Columbia will continue to have the lowest incidence. Female incidence rates are predicted to increase 10%, 3% and 1% in Ontario, Quebec and the Atlantic region, respectively, and decrease 9% and 7% in British Columbia and the Prairies by 2028-2032.

Observed most common cancers by sex and age

Figures 3.8 and 3.9 show the most common newly diagnosed cancers by sex and age group for 1983–1987 and 2003–2007. Overall, 52% of new cases in the last observation period (2003–2007) were in males and 48% in females. For males in each period, prostate, lung and colorectum were among the most frequently diagnosed cancer sites, together accounting for just over half the cases. In the last period the incidence of prostate cancer had replaced lung cancer in first place, followed by cancers of the colorectum and bladder. These cancers were similarly distributed for males within the various age groups, with some variation in proportions and ranking. The only exception was the youngest age group (<45 years), in which testis cancer was the most common newly diagnosed cancer. The incidence of testis cancer increased over the 2 periods of study. Other common cancers in the youngest males included non-Hodgkin lymphoma (NHL), leukemia and cancer of the central nervous system (CNS). Prostate cancer cases in men aged 45 to 74 increased markedly and occurred with the highest frequency in the most recent period, as a prevalent pool of undiagnosed cancers were detected by prostate-specific antigen (PSA) screening.Endnote 36

FIGURE 3.8
Most common newly diagnosed cancers in Canada, 1983–1987

Most common newly diagnosed cancers in Canada, 1983–1987

[Click to enlarge]

[FIGURE 3.8, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 3.8
Most common newly diagnosed cancers in Canada, 1983-1987

For males, lung, prostate, and colorectum were among the most frequently diagnosed cancer sites, together accounting for just over half the cases. The cancers were similarly distributed for males within each age group of 55 or older, with some variation in proportions and ranking. The only exception was the youngest age group (<45 years), in which testis cancer was the most common newly diagnosed cancer. Breast cancer dominated cancer incidence in females, representing 27% of all diagnoses, followed by colorectal and lung cancers. The top 3 cancer diagnoses for females within each age group of 45 or older were these same 3, but with changes in proportions and ranking. For the youngest females (<45 years), the most common newly diagnosed cancer was breast cancer, with 30% of new cases. The other common cancers in this age group included cervical cancer, melanoma, and thyroid cancer.


Figure 3.8 - Footnote a
Total of rounded numbers may not equal rounded total number;
Figure 3.8 - Footnote b
CNS refers to central nervous system cancer;
Figure 3.8 - Footnote c
NHL refers to non-Hodgkin lymphoma.

FIGURE 3.9
Most common newly diagnosed cancers in Canada, 2003–2007

Most common newly diagnosed cancers in Canada, 2003–2007

[Click to enlarge]

[FIGURE 3.9, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 3.9
Most common newly diagnosed cancers in Canada, 2003-2007

Overall, 52% of new cases were in males and 48% in females. For males, prostate, lung and colorectum were among the most frequently diagnosed cancer sites, together accounting for just over half the cases. The top 3 cancer diagnoses for males within each age group of 45 or older were these same 3, but with some variation in proportions and ranking. The only exception was the youngest age group (<45 years), in which testis cancer was the most common cancer. Other common cancers in the youngest males included non-Hodgkin lymphoma, leukemia and cancer of the central nervous system. Breast cancer dominated cancer incidence in females, representing 27% of all diagnoses, followed by lung and colorectal cancers. The top 3 cancer diagnoses for females within each age group of 45 or older were these same 3, but with changes in proportions and ranking. For the youngest females (<45 years), the most common cancer was breast cancer, with 30% of new cases. The other common cancers in this age group included thyroid, cervical cancers and melanoma.


Figure 3.9 - Footnote a
Total of rounded numbers may not equal rounded total number;
Figure 3.9 - Footnote b
CNS refers to central nervous system cancer;
Figure 3.9 - Footnote c
NHL refers to non-Hodgkin lymphoma.

Breast cancer dominated cancer incidence in females, representing the same proportion of 27% of all diagnoses in the 2 periods studied, followed by lung and colorectal cancers (which had switched places between 1983–1987 and 2003–2007). The top 3 cancer diagnoses for females within each age group of 45 or older were these same 3, but with slight variations in rank. For the youngest females (<45 years), the most common newly diagnosed cancer was breast cancer, with 30% of new cases. The other common cancers in this age group included thyroid, cervical cancers and melanoma.

The most noticeable difference between males and females under 45 was the much higher proportion of thyroid cancer incidence in females. The most dramatic changes in the incidence proportions of different types of cancer as a function of age (<45 and 45+) occurred with melanoma, leukemia, CNS tumours, NHL, thyroid and genital tract malignancies.

The incidence proportions (by 10-year age group) of lung cancer in males aged 45 to 74 decreased by 7% to 12% between 1983–1987 and 2003–2007, whereas the incidence proportions of prostate cancer increased more pronouncedly (10%–20%) over the 2 periods for the same age groups. The incidence share attributed to NHL also registered some increase in the 2 youngest age groups, while the proportion of stomach cancer incidence decreased in each age group.

The increase of 6% to 8% between the study periods in the incidence proportion of lung cancer in women 65 or older is notable. A similar trend was observed in European countries.Endnote 4 The proportional increase in lung cancer incidence in females of all ages was 4% from 1983–1987 to 2003–2007. The incidence percentage also increased notably for NHL in women aged 65 to 84 and for thyroid cancer in those under 55. The proportion of breast cancer incidence increased by 2% to 3% in women aged between 45 and 64. This increased share for breast cancer may be partly attributable to the impact of early detection with the increased uptake of mammography screening. There was a marked reduction in the incidence proportion for cervical cancer in females aged under 45 as well as noteworthy reductions in the incidence proportions for stomach cancer and colorectal cancer in all female age groups. Many more cervical cancers are prevented by screening each year.

Projected most common cancers by sex and age

As the projected change in cancer incidence is attributable primarily to demographic factors, the relative frequencies of major cancers are not expected to change significantly. Figure 3.10 shows the cancer types that are projected to be newly diagnosed with the greatest frequency in 2028–2032 by sex and age group. By 2028–2032, colorectal cancer is projected to have overtaken lung cancer as the second most frequently diagnosed cancer in males, even though colorectal cancer will maintain a similar percentage of the total cancer cases in males as during 2003–2007. This change in ranking is the result of a decrease of 27% in the incidence of lung cancer as a proportion of all cancers, reflecting the historical reduction in smoking prevalence after accounting for a lag period.Endnote 42, Endnote 43, Endnote 44, bladder (6%) and NHL (4%). The age-specific analysis indicates that, between 2003–2007 and 2028–2032, the incidence of lung cancer in males (as a proportion of total cancer cases) will decrease by 19%, 34%, 32%, 30%and 21% for each of the 10-year age groups from 45 to 85 and over, respectively. Another notable change in the incidence frequency will be the 32% decrease in the melanoma incidence proportion in the youngest males (<45 years). Cancers of the prostate, colorectum and lung are projected to be the top 3 most common types, in that order, within each age group from 45 years and older.

FIGURE 3.10
Projected most common newly diagnosed cancers in Canada, 2028–2032

Projected most common newly diagnosed cancers in Canada, 2028–2032

[Click to enlarge]

[FIGURE 3.10, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 3.10
Projected most common newly diagnosed cancers in Canada, 2028-2032

Figure 3.10 shows the cancer types that are projected to be newly diagnosed with the greatest frequency in 2028-2032 by sex and age group. In males, the most common cancers in 2028-2032 are projected to be prostate cancer (28%), colorectal (13%), lung (11%), bladder (6%) and NHL (4%). Cancers of the prostate, colorectum and lung are projected to be the top 3 most common types, in that order, within each age group from 45 years and older. For females, the most commonly diagnosed cancers in 2028-2032 are projected to be breast cancer (24%), lung cancer (12%), colorectal cancer (12%), uterine cancer (6%), thyroid cancer (5%) and NHL (4%). For the youngest females (<45 years), the most common newly diagnosed cancers will be breast, thyroid and cervical cancers and melanoma.


Figure 3.10 - Footnote a
Total of rounded numbers may not equal rounded total number;
Figure 3.10 - Footnote b
CNS refers to central nervous system cancer;
Figure 3.10 - Footnote c
NHL refers to non-Hodgkin lymphoma.

For females, the top 4 most common incident cancers are expected to remain the same as in the last observation period (2003–2007). However, thyroid cancer will outrank NHL as the fifth most common cancer. Specifically, the most commonly diagnosed cancers in females in 2028–2032 are projected to be breast cancer (24%), lung cancer (12%), colorectal cancer (12%), uterine cancer (6%), thyroid cancer (5%) and NHL (4%). The overall increase in thyroid cancer will be mainly from the proportional increases of 67% in women aged 45 to 54, 140%in those aged 55 to 64, and 105% in those aged 65 to 74. The 26% predicted reduction in the incidence proportion for cervical cancer in females under 45 will underscore the further success of prevention and screening programs.Endnote 45, Endnote 46 Compared with the 2003–2007 age-specific results, the projected most common incident cancers in females will be the same within each 10-year age group, but with changes in ranking order for the under-65 and 75–84 age groups. The cancers in the ‘Other’ category, together representing just over one-third of all new cancer cases, will be examined in Chapter 4.

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