Together we can end bowel cancer as we know it

Bowel cancer in NSW: The factsBe informed • Take action • Save lives

Bowel cancer is commonMany people don’t realise the full extent of its impact

Bowel cancer incidence in NSW has remained high for the last 2 to 3 decades

One in

people in NSWwill be diagnosed by the age of 85

1 in 10 men, and

1 in 14 women will be diagnosed

Note: Risk of being diagnosed with bowel cancer by the age of 85, based on NSW incidence 2010.* Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013 [cited 2015 May 06].

Note: Incidence has been age-standardised to the Australian 2001 standard population.Sources: NSW Cancer Registry and NSW Secure Analytics for Population Health Research and Intelligence.

Australia and New Zealand have the highest incidence of bowel cancer in the world.*

of all cancer deaths in NSW

In 2010, bowel cancer accounted for

13%

Many people die of bowel cancerBowel cancer is the second biggest cancer killer in Australia and NSW

Bowel cancer kills more people in NSW than prostate cancer, breast cancer or melanoma

Source: NSW Cancer Registry

Bowel cancer is most treatablewhen diagnosed at an early stage

The good news is that 5-year survival is 89% in localised disease

Compared with 16% in distant disease.

89%

localised 16%

distantVS

Note: Survival by extent of disease is based on 5-year net survival of NSW cases diagnosed 2005-2009 and followed up to 2013.Sources: NSW Cancer Registry and National Death Index Australia.

Screening leads to lower bowel cancer mortalitythrough early detection

But currently only 33% of eligible people in NSW take part in bowel cancer screening

If bowel screening participation ratesincreased to 60% in NSW

and across Australia, up to

lives could be saved from bowel cancer over the next 40 years.*

90,000

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61. Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

PreventionReduce the risk of bowel cancer

Obesity is linked to increased risk of

bowel cancer.

Staying physically active and lean can

lower your risk.

Physical activity

Smoking increases the risk of bowel cancer.

The following services are available for more

information and support on how to quit.

Quit smoking

Several dietary factors are linked to bowel

cancer risk.

Increased riskRed meat

Processed meatExcessive alcohol

Decreased riskDietary fibre

Healthy diet

NSW delivers world’s best outcomes for bowel cancerIt is important to seek treatment once diagnosed...

with radiotherapy and surgery

In some instances, additional treatments can reduce the chance of the cancer returning

Survival from bowel cancer in NSW is better than comparative countries

with radiotherapy and surgery

with only surgery

vs 5%Cancer returns within 10 years of treatment

11%of rectal cancer cases

of rectal cancer cases

Bowel cancer, 5-year relative survival, in selected countries, diagnosed 2005-2007

Note: Relative survival was estimated using the period method for cases diagnosed 2005-2007 and followed up to 2007, and has been age-standardised to the International Cancer Survival Standard Weights.Source: Coleman MP, Forman D, Bryant H et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 2011; 377:127-38.

Note: Based on a sample of international patients.Source: van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575-82.

Together we can end bowel cancer as we know it

Bowel cancer in NSW: The factsBe informed • Take action • Save lives

Bowel cancer is commonMany people don’t realise the full extent of its impact

One in

people in NSWwill be diagnosed by the age of 85

1 in 10 men, and

1 in 14 women will be diagnosed

Note: Risk of being diagnosed with bowel cancer by the age of 85, based on NSW incidence 2010.*Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013 [cited 2015 May 06].

Note: Incidence has been age-standardised to the Australian 2001 standard population.Sources: NSW Cancer Registry and NSW Secure Analytics for Population Health Research and Intelligence.

Australia and New Zealand have the highest incidence of bowel cancer in the world*

Bowel cancer incidence in NSW has remained high for the last 2 to 3 decades

of all cancer deaths in NSW

In 2010, bowel cancer accounted for

13%

Many people die of bowel cancerBowel cancer is the second biggest cancer killer in Australia and NSW after lung cancer.

Bowel cancer kills more people in NSW than prostate cancer, breast cancer or melanoma

Source: NSW Cancer Registry

The outlook for bowel cancer is bestwhen it is diagnosed at an early stage

The good news is that 5-year survival is 89% in localised disease

Compared with 16% in distant disease.

89%

localised 16%

distantVS

Note: Survival by extent of disease is based on 5-year net survival of NSW cases diagnosed 2005-2009 and followed up to 2013.Sources: NSW Cancer Registry and National Death Index Australia.

Screening leads to lower bowel cancer mortalitythrough early detection

Bowel cancer, distribution of stage at diagnosis in unscreened vs. screened scenario*, incident cases in NSW projected for 2016

Notes:*Unknown stage is not shown. Distribution of stage at diagnosis in unscreened vs. screened scenario is based on Ananda SS, McLaughlin SJ, Chen F et al. Initial impact of Australia’s National Bowel Cancer Screening Program. Med J Aust 2009; 191:378-81.

Dukes A

Stage I Stage II Stage III

Dukes B Dukes C

Stage IV

screened

unscreened

Extent of disease at diagnosis

Perc

enta

ge

14%

40%

31%

25% 24%25%

15%

3%

• Bowel cancer screening by faecal occult blood testing can detect more cancers at an earlier stage, when treatment is more effective and less invasive, and mortality is lower

• Screening can even prevent bowel cancer by detecting pre-cancerous lesions

Dukes D

Screening participation rates for bowel cancer need to increase for more people to benefit

Currently only 33% of eligible people in NSW take part in bowel cancer screening

If bowel screening participation ratesincreased to 60% in NSW

and across Australia, up to

lives could be saved from bowel cancer over the next 40 years.*

90,000

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61. Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

PreventionReduce the risk of bowel cancer

Obesity is linked to increased risk of

bowel cancer.

Staying physically active and lean can

lower your risk.

Physical activity

Smoking increases the risk of bowel cancer.

The following services are available for more

information and support on how to quit.

Quit smoking

Several dietary factors are linked to bowel

cancer risk.

Increased riskRed meat

Processed meatExcessive alcohol

Decreased riskDietary fibre

Healthy diet

NSW delivers world’s best outcomes for bowel cancerIt is important to seek treatment once diagnosed...

with radiotherapy and surgery

While surgery is the mainstay of curative treatment for bowel cancer, adjuvant therapy can further

improve outcomes for suitable patients

Survival from bowel cancer in NSW is better than comparative countries

with radiotherapy and surgery

with only surgery

vs 5%Cancer returns within 10 years of treatment

11%of rectal cancer cases

of rectal cancer cases

Bowel cancer, 5-year relative survival, in selected countries, diagnosed 2005-2007

Note: Relative survival was estimated using the period method for cases diagnosed 2005-2007 and followed up to 2007, and has been age-standardised to the International Cancer Survival Standard Weights.Source: Coleman MP, Forman D, Bryant H et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 2011; 377:127-38.

Note: Based on a sample of international patients.Source: van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575-82.

Together we can end bowel cancer as we know it

Bowel cancer in NSW: The factsBe informed • Take action • Save lives

Bowel cancer is commonMany people don’t realise the full extent of its impact

One in

people in NSWwill be diagnosed by the age of 85

1 in 10 men, and

1 in 14 women will be diagnosed

Note: Risk of being diagnosed with bowel cancer by the age of 85, based on NSW incidence 2010.*Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013 [cited 2015 May 06].

Note: Incidence has been age-standardised to the Australian 2001 standard population.Sources: NSW Cancer Registry and NSW Secure Analytics for Population Health Research and Intelligence.

Australia and New Zealand have the highest incidence of bowel cancer in the world.*

Bowel cancer incidence in NSW has remained high for the last 2 to 3 decades

of all cancer deaths in NSW

In 2010, bowel cancer accounted for

13%

Many people die of bowel cancerBowel cancer is the second biggest cancer killer in Australia and NSW after lung cancer.

Bowel cancer kills more people in NSW than prostate cancer, breast cancer or melanoma

Source: NSW Cancer Registry

Bowel cancer is most treatablewhen diagnosed at an early stage

The good news is that 5-year survival is 89% in localised disease

Compared with 16% in distant disease.

89%

localised 16%

distantVS

Note: Survival by extent of disease is based on 5-year net survival of NSW cases diagnosed 2005-2009 and followed up to 2013.Sources: NSW Cancer Registry and National Death Index Australia.

Screening leads to lower bowel cancer mortalitythrough early detection

If bowel screening participation ratesincreased to 60% in NSW

and across Australia, up to

lives could be saved from bowel cancer over the next 40 years.*

90,000

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61. Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

Low risk Medium risk High risk

2.7xincreased risk

of death

3.5xincreased risk

of death

36%

50%47%

36%

17%14%

Screening leads to lower bowel cancer mortalitythrough early detection

But currently only 33% of eligible people in NSW take part in bowel cancer screening

If bowel screening participation ratesincreased to 60% in NSW

and across Australia, up to

lives could be saved from bowel cancer over the next 40 years.*

90,000

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61. Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

PreventionReduce the risk of bowel cancer

Obesity is linked to increased risk of

bowel cancer.

Staying physically active and lean can

lower your risk.

Physical activity

Smoking increases the risk of bowel cancer.

The following services are available for more

information and support on how to quit.

Quit smoking

Several dietary factors are linked to bowel

cancer risk.

Increased riskRed meat

Processed meatExcessive alcohol

Decreased riskDietary fibre

Healthy diet

NSW delivers world’s best outcomes for bowel cancerIt is important to seek treatment once diagnosed...

with radiotherapy and surgery

In some instances, additional treatments can reduce the chance of the cancer returning

Survival from bowel cancer in NSW is better than comparative countries

with radiotherapy and surgery

with only surgery

vs 5%Cancer returns within 10 years of treatment

11%of rectal cancer cases

of rectal cancer cases

Bowel cancer, 5-year relative survival, in selected countries, diagnosed 2005-2007

Note: Relative survival was estimated using the period method for cases diagnosed 2005-2007 and followed up to 2007, and has been age-standardised to the International Cancer Survival Standard Weights.Source: Coleman MP, Forman D, Bryant H et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 2011; 377:127-38.

Note: Based on a sample of international patients.Source: van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575-82.

Together we can end bowel cancer as we know it

Bowel cancer in NSW: The factsBe informed • Take action • Save lives

Bowel cancer is commonMany people don’t realise the full extent of its impact

One in

people in NSWwill be diagnosed by the age of 85

1 in 10 men, and

1 in 14 women will be diagnosed

Note: Risk of being diagnosed with bowel cancer by the age of 85, based on NSW incidence 2010.*Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013 [cited 2015 May 06].

Note: Incidence has been age-standardised to the Australian 2001 standard population.Sources: NSW Cancer Registry and NSW Secure Analytics for Population Health Research and Intelligence.

Australia and New Zealand have the highest incidence of bowel cancer in the world.*

Bowel cancer incidence in NSW has remained high for the last 2 to 3 decades

of all cancer deaths in NSW

In 2010, bowel cancer accounted for

13%

Many people die of bowel cancerBowel cancer is the second biggest cancer killer in Australia and NSW after lung cancer.

Bowel cancer kills more people in NSW than prostate cancer, breast cancer or melanoma

Source: NSW Cancer Registry

The outlook for bowel cancer is bestwhen it is diagnosed at an early stage

The good news is that 5-year survival is 89% in localised disease

Compared with 16% in distant disease.

89%

localised 16%

distantVS

Note: Survival by extent of disease is based on 5-year net survival of NSW cases diagnosed 2005-2009 and followed up to 2013.Sources: NSW Cancer Registry and National Death Index Australia.

Screening leads to lower bowel cancer mortalitythrough early detection

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

Low risk Medium risk High risk

2.7xincreased risk

of death

3.5xincreased risk

of death

36%

50%47%

36%

17%14%

Low risk

Localised Regionalised Distant

Medium risk High risk

2.7 timesincreased risk of death

3.5 timesincreased risk of death

potential results with earlyscreening

current results

If more people screened, more cancers can be detected at low risk stage

Extent of disease at diagnosis

Perc

enta

ge

36%

50%47%

36%

17%14%

Screening leads to lower bowel cancer mortalitythrough early detection

But currently only 33% of eligible people in NSW take part in bowel cancer screening

If bowel screening participation ratesincreased to 60% in NSW

and across Australia, up to

lives could be saved from bowel cancer over the next 40 years.*

90,000

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61. Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

PreventionReduce the risk of bowel cancer

Obesity is linked to increased risk of

bowel cancer.

Staying physically active and lean can

lower your risk.

Physical activity

Smoking increases the risk of bowel cancer.

The following services are available for more

information and support on how to quit.

Quit smoking

Several dietary factors are linked to bowel

cancer risk.

Increased riskRed meat

Processed meatExcessive alcohol

Decreased riskDietary fibre

Healthy diet

NSW delivers world’s best outcomes for bowel cancerIt is important to seek treatment once diagnosed...

with radiotherapy and surgery

In some instances, additional treatments can reduce the chance of the cancer returning

Survival from bowel cancer in NSW is better than comparative countries

with radiotherapy and surgery

with only surgery

vs 5%Cancer returns within 10 years of treatment

11%of rectal cancer cases

of rectal cancer cases

Bowel cancer, 5-year relative survival, in selected countries, diagnosed 2005-2007

Note: Relative survival was estimated using the period method for cases diagnosed 2005-2007 and followed up to 2007, and has been age-standardised to the International Cancer Survival Standard Weights.Source: Coleman MP, Forman D, Bryant H et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 2011; 377:127-38.

Note: Based on a sample of international patients.Source: van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575-82.

Together we can end bowel cancer as we know it

Bowel cancer in NSW: The factsBe informed • Take action • Save lives

Bowel cancer is commonMany people don’t realise the full extent of its impact

One in

people in NSWwill be diagnosed by the age of 85

1 in 10 men, and

1 in 14 women will be diagnosed

Note: Risk of being diagnosed with bowel cancer by the age of 85, based on NSW incidence 2010.*Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013 [cited 2015 May 06].

Note: Incidence has been age-standardised to the Australian 2001 standard population.Sources: NSW Cancer Registry and NSW Secure Analytics for Population Health Research and Intelligence.

Australia and New Zealand have the highest incidence of bowel cancer in the world*

Bowel cancer incidence in NSW has remained high for the last 2 to 3 decades

of all cancer deaths in NSW

In 2010, bowel cancer accounted for

13%

Many people die of bowel cancerBowel cancer is the second biggest cancer killer in Australia and NSW after lung cancer.

Bowel cancer kills more people in NSW than prostate cancer, breast cancer or melanoma

Source: NSW Cancer Registry

The outlook for bowel cancer is bestwhen it is diagnosed at an early stage

The good news is that 5-year survival is 89% in localised disease

Compared with 16% in distant disease.

89%

localised 16%

distantVS

Note: Survival by extent of disease is based on 5-year net survival of NSW cases diagnosed 2005-2009 and followed up to 2013.Sources: NSW Cancer Registry and National Death Index Australia.

Screening leads to lower bowel cancer mortalitythrough early detection

Bowel cancer, distribution of stage at diagnosis in unscreened vs. screened scenario

Notes: Unknown stage is not shown.Source: Ananda SS, McLaughlin SJ, Chen F et al. Initial impact of Australia’s National Bowel Cancer Screening Program. Med J Aust 2009; 191:378-81.

Stage I Stage II Stage III

Diagnosed through screening (screened)

Not diagnosed throughscreening (unscreened)

Stage at diagnosis

Perc

enta

ge o

f cas

es

14%

40%

31%

25% 24%25%

15%

3%

• Bowel cancer screening by faecal occult blood testing can detect more cancers at an earlier stage, when treatment is more effective and less invasive, and mortality is lower.

• Screening can even prevent bowel cancer by detecting pre-cancerous lesions.

Stage IV

Screening participation rates for bowel cancer need to increase for more people to benefit

Currently only 33% of eligible people in NSW take part in bowel cancer screening

If bowel screening participation ratesincreased to 60% in NSW

and across Australia, up to

lives could be saved from bowel cancer over the next 40 years.*

90,000

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61. Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

PreventionReduce the risk of bowel cancer

Obesity is linked to increased risk of

bowel cancer.

Staying physically active and lean can

lower your risk.

Physical activity

Smoking increases the risk of bowel cancer.

The following services are available for more

information and support on how to quit.

Quit smoking

Several dietary factors are linked to bowel

cancer risk.

Increased riskRed meat

Processed meatExcessive alcohol

Decreased riskDietary fibre

Healthy diet

NSW delivers world’s best outcomes for bowel cancerIt is important to seek treatment once diagnosed...

with radiotherapy and surgery

While surgery is the mainstay of curative treatment for bowel cancer, adjuvant therapy can further

improve outcomes for suitable patients

Survival from bowel cancer in NSW is better than comparative countries

with radiotherapy and surgery

with only surgery

vs 5%Cancer returns within 10 years of treatment

11%of rectal cancer cases

of rectal cancer cases

Bowel cancer, 5-year relative survival, in selected countries, diagnosed 2005-2007

Note: Relative survival was estimated using the period method for cases diagnosed 2005-2007 and followed up to 2007, and has been age-standardised to the International Cancer Survival Standard Weights.Source: Coleman MP, Forman D, Bryant H et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 2011; 377:127-38.

Note: Based on a sample of international patients.Source: van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575-82.

Together we can end bowel cancer as we know it

Bowel cancer in NSW: The factsBe informed • Take action • Save lives

Bowel cancer is commonMany people don’t realise the full extent of its impact

One in

people in NSWwill be diagnosed by the age of 85

1 in 10 men, and

1 in 14 women will be diagnosed

Note: Risk of being diagnosed with bowel cancer by the age of 85, based on NSW incidence 2010.*Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013 [cited 2015 May 06].

Note: Incidence has been age-standardised to the Australian 2001 standard population.Sources: NSW Cancer Registry and NSW Secure Analytics for Population Health Research and Intelligence.

Australia and New Zealand have the highest incidence of bowel cancer in the world.*

Bowel cancer incidence in NSW has remained high for the last 2 to 3 decades

of all cancer deaths in NSW

In 2010, bowel cancer accounted for

13%

Many people die of bowel cancerBowel cancer is the second biggest cancer killer in Australia and NSW after lung cancer.

Bowel cancer kills more people in NSW than prostate cancer, breast cancer or melanoma

Source: NSW Cancer Registry

The outlook for bowel cancer is bestwhen it is diagnosed at an early stage

The good news is that 5-year survival is 89% in localised disease

Compared with 16% in distant disease.

89%

localised 16%

distantVS

Note: Survival by extent of disease is based on 5-year net survival of NSW cases diagnosed 2005-2009 and followed up to 2013.Sources: NSW Cancer Registry and National Death Index Australia.

Screening leads to lower bowel cancer mortalitythrough early detection

Bowel cancer, distribution of stage at diagnosis in unscreened vs. screened scenario*, incident cases in NSW projected for 2016

Notes:*Unknown stage is not shown. Distribution of stage at diagnosis in unscreened vs. screened scenario is based on Ananda SS, McLaughlin SJ, Chen F et al. Initial impact of Australia’s National Bowel Cancer Screening Program. Med J Aust 2009; 191:378-81.

Dukes A

Stage I Stage II Stage III

Dukes B Dukes C

Stage IV

screened

unscreened

Extent of disease at diagnosis

Perc

enta

ge

14%

40%

31%

25% 24%25%

15%

3%

• Bowel cancer screening by faecal occult blood testing can detect more cancers at an earlier stage, when treatment is more effective and less invasive, and mortality is lower

• Screening can even prevent bowel cancer by detecting pre-cancerous lesions

Dukes D

Screening participation rates for bowel cancer need to increase for more people to benefit

Currently only 33% of eligible people in NSW take part in bowel cancer screening

If bowel screening participation ratesincreased to 60% in NSW

and across Australia, up to

lives could be saved from bowel cancer over the next 40 years.*

90,000

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61. Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

PreventionReduce the risk of bowel cancer

Obesity is linked to increased risk of

bowel cancer.

Staying physically active and lean can

lower your risk.

Physical activity

Smoking increases the risk of bowel cancer.

The following services are available for more

information and support on how to quit.

Quit smoking

Several dietary factors are linked to bowel

cancer risk.

Increased riskRed meat

Processed meatExcessive alcohol

Decreased riskDietary fibre

Healthy diet

NSW delivers world’s best outcomes for bowel cancerIt is important to seek treatment once diagnosed...

with radiotherapy and surgery

In some instances, additional treatments can reduce the chance of the cancer returning

Survival from bowel cancer in NSW is better than comparative countries

with radiotherapy and surgery

with only surgery

vs 5%Cancer returns within 10 years of treatment

11%of rectal cancer cases

of rectal cancer cases

Bowel cancer, 5-year relative survival, in selected countries, diagnosed 2005-2007

Note: Relative survival was estimated using the period method for cases diagnosed 2005-2007 and followed up to 2007, and has been age-standardised to the International Cancer Survival Standard Weights.Source: Coleman MP, Forman D, Bryant H et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 2011; 377:127-38.

Note: Based on a sample of international patients.Source: van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575-82.

Together we can end bowel cancer as we know it

Bowel cancer in NSW: The factsBe informed • Take action • Save lives

Bowel cancer is commonMany people don’t realise the full extent of its impact

Bowel cancer incidence in NSW has remained high for the last 2 to 3 decades

One in

people in NSWwill be diagnosed by the age of 85

1 in 10 men, and

1 in 14 women will be diagnosed

Note: Risk of being diagnosed with bowel cancer by the age of 85, based on NSW incidence 2010.* Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013 [cited 2015 May 06].

Note: Incidence has been age-standardised to the Australian 2001 standard population.Sources: NSW Cancer Registry and NSW Secure Analytics for Population Health Research and Intelligence.

Australia and New Zealand have the highest incidence of bowel cancer in the world.*

of all cancer deaths in NSW

In 2010, bowel cancer accounted for

13%

Many people die of bowel cancerBowel cancer is the second biggest cancer killer in Australia and NSW

Bowel cancer kills more people in NSW than prostate cancer, breast cancer or melanoma

Source: NSW Cancer Registry

Bowel cancer is most treatablewhen diagnosed at an early stage

The good news is that 5-year survival is 89% in localised disease

Compared with 16% in distant disease.

89%

localised 16%

distantVS

Note: Survival by extent of disease is based on 5-year net survival of NSW cases diagnosed 2005-2009 and followed up to 2013.Sources: NSW Cancer Registry and National Death Index Australia.

Screening leads to lower bowel cancer mortalitythrough early detection

But currently only 33% of eligible people in NSW take part in bowel cancer screening

If bowel screening participation ratesincreased to 60% in NSW

and across Australia, up to

lives could be saved from bowel cancer over the next 40 years.*

90,000

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61. Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

PreventionReduce the risk of bowel cancer

Obesity is linked to increased risk of

bowel cancer.

Staying physically active and lean can

lower your risk.

Physical activity

Smoking increases the risk of bowel cancer.

The following services are available for more

information and support on how to quit.

Quit smoking

Several dietary factors are linked to bowel

cancer risk.

Increased riskRed meat

Processed meatExcessive alcohol

Decreased riskDietary fibre

Healthy diet

NSW delivers world’s best outcomes for bowel cancerIt is important to seek treatment once diagnosed...

with radiotherapy and surgery

In some instances, additional treatments can reduce the chance of the cancer returning

Survival from bowel cancer in NSW is better than comparative countries

with radiotherapy and surgery

with only surgery

vs 5%Cancer returns within 10 years of treatment

11%of rectal cancer cases

of rectal cancer cases

Bowel cancer, 5-year relative survival, in selected countries, diagnosed 2005-2007

Note: Relative survival was estimated using the period method for cases diagnosed 2005-2007 and followed up to 2007, and has been age-standardised to the International Cancer Survival Standard Weights.Source: Coleman MP, Forman D, Bryant H et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 2011; 377:127-38.

Note: Based on a sample of international patients.Source: van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575-82.

Together we can end bowel cancer as we know it

Bowel cancer in NSW: The factsBe informed • Take action • Save lives

Bowel cancer is commonMany people don’t realise the full extent of its impact

One in

people in NSWwill be diagnosed by the age of 85

1 in 10 men, and

1 in 14 women will be diagnosed

Note: Risk of being diagnosed with bowel cancer by the age of 85, based on NSW incidence 2010.*Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013 [cited 2015 May 06].

Note: Incidence has been age-standardised to the Australian 2001 standard population.Sources: NSW Cancer Registry and NSW Secure Analytics for Population Health Research and Intelligence.

Australia and New Zealand have the highest incidence of bowel cancer in the world.*

Bowel cancer incidence in NSW has remained high for the last 2 to 3 decades

of all cancer deaths in NSW

In 2010, bowel cancer accounted for

13%

Many people die of bowel cancerBowel cancer is the second biggest cancer killer in Australia and NSW after lung cancer.

Bowel cancer kills more people in NSW than prostate cancer, breast cancer or melanoma

Source: NSW Cancer Registry

The outlook for bowel cancer is bestwhen it is diagnosed at an early stage

The good news is that 5-year survival is 89% in localised disease

Compared with 16% in distant disease.

89%

localised 16%

distantVS

Note: Survival by extent of disease is based on 5-year net survival of NSW cases diagnosed 2005-2009 and followed up to 2013.Sources: NSW Cancer Registry and National Death Index Australia.

Screening leads to lower bowel cancer mortalitythrough early detection

Bowel cancer, distribution of stage at diagnosis in unscreened vs. screened scenario*, incident cases in NSW projected for 2016

Notes:*Unknown stage is not shown. Distribution of stage at diagnosis in unscreened vs. screened scenario is based on Ananda SS, McLaughlin SJ, Chen F et al. Initial impact of Australia’s National Bowel Cancer Screening Program. Med J Aust 2009; 191:378-81.

Dukes A

Stage I Stage II Stage III

Dukes B Dukes C

Stage IV

screened

unscreened

Extent of disease at diagnosis

Perc

enta

ge

14%

40%

31%

25% 24%25%

15%

3%

• Bowel cancer screening by faecal occult blood testing can detect more cancers at an earlier stage, when treatment is more effective and less invasive, and mortality is lower

• Screening can even prevent bowel cancer by detecting pre-cancerous lesions

Dukes D

Screening participation rates for bowel cancer need to increase for more people to benefit

Currently only 33% of eligible people in NSW take part in bowel cancer screening

If bowel screening participation ratesincreased to 60% in NSW

and across Australia, up to

lives could be saved from bowel cancer over the next 40 years.*

90,000

Cancer screening, screening participation rates, by screening type, NSW, 2012-2014

* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61. Notes:• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012 to June 2014.• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.

Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

PreventionReduce the risk of bowel cancer

Obesity is linked to increased risk of

bowel cancer.

Staying physically active and lean can

lower your risk.

Physical activity

Smoking increases the risk of bowel cancer.

The following services are available for more

information and support on how to quit.

Quit smoking

Several dietary factors are linked to bowel

cancer risk.

Increased riskRed meat

Processed meatExcessive alcohol

Decreased riskDietary fibre

Healthy diet

NSW delivers world’s best outcomes for bowel cancerIt is important to seek treatment once diagnosed...

with radiotherapy and surgery

While surgery is the mainstay of curative treatment for bowel cancer, adjuvant therapy can further

improve outcomes for suitable patients

Survival from bowel cancer in NSW is better than comparative countries

with radiotherapy and surgery

with only surgery

vs 5%Cancer returns within 10 years of treatment

11%of rectal cancer cases

of rectal cancer cases

Bowel cancer, 5-year relative survival, in selected countries, diagnosed 2005-2007

Note: Relative survival was estimated using the period method for cases diagnosed 2005-2007 and followed up to 2007, and has been age-standardised to the International Cancer Survival Standard Weights.Source: Coleman MP, Forman D, Bryant H et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 2011; 377:127-38.

Note: Based on a sample of international patients.Source: van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575-82.