Status of Radiotherapy around the World: Australia, New Zealand and Papua New Guinea. Chapter 25.8

Australia has a population of over 22 million and New Zealand 4 million people. Both are classified as high income countries. In 2007, there were over 100 000 new cases of cancer diagnosed in Australia (excluding basal and squamous cell carcinoma of the skin), with the most commonly diagnosed cancers being prostate, bowel, breast, melanoma of the skin and lung cancer. The incidence profiles are similar in New Zealand. In both countries, lung cancer accounted for the most cancer deaths in 2008 (19%), followed by colorectal, prostate and breast cancers. In Australia, the age standardized death rate per 100 000 population due to cancer is 140.8 for men and 92.9 for women. The relative survival rate for cancer patients in Australia is among the best in an international comparison of six developed nations. Radiotherapy services across Australia and New Zealand are predominantly outpatient based and provided in public sector specialist cancer care facilities. According to the IAEA's DIRAC database, there are currently 69 radiotherapy centres in Australia and eight in New Zealand. Megavoltage linacs for standard 3-D external beam radiotherapy, brachytherapy, as well as stereotactic radiotherapy for both cranial and extracranial applications are available in selected large metropolitan based centres. Across Australia and New Zealand, a wide range of current imaging technologies, including CT, magnetic resonance imaging (MRI), and positron emission tomography, are available for incorporation into radiation treatment planning. IMRT was first introduced around 2001 for head and neck cancers and is now available in most radiotherapy centres for selected tumour sites and clinical indications. Papua New Guinea, classified in the low and middle income group, has a current population of over 6.8 million people dispersed over 600 islands. Registrations at the National Cancer Registry do not document the true burden of cancer in Papua New Guinea. It is estimated that there are over 16 000 new cancer cases annually, and conservatively at least 12 750 deaths per year due to cancer, giving Papua New Guinea one of the world's highest per capita cancer rates. Cancers account for about 8% of all deaths. The age standardized death rate per 100 000 due to cancer is 151.8 for men and 106.9 for women. The four cancers with the highest incidence are oral cavity, cervix, liver and breast, the burden of which disproportionately affects women. However, three of these cancers are potentially preventable. Relevant prevention strategies include tobacco and betel nut control, hepatitis B virus vaccination and HPV vaccination, together with cervical cancer screening.