Increasing 'active prevalence' of cancer in Western Australia and its implications for health services

Objective: To measure the active and total prevalence of cancer in Western Australia from 1990-98 and to examine trends in utilisation of hospital services by prevalent cancer patients. Method: Longitudinal analysis of linked cancer registrations, hospital separations and death registrations in Western Australia in 1990-98 using a population-based record linkage system. Results: There was an estimated total of 53,450 patients ever-diagnosed with cancer in Western Australia at 30 June 1998 (29.7 per 1,000 population), an increase of 51% since mid-1990 (21.9/1,000). Patients with active disease accounted for 25% of the total prevalence, and the active prevalence of cancer increased from 5.1/1,000 in 1990 to 7.4/1,000 in 1998. In patients with active cancer, hospital admission rates for procedures other than chemotherapy and radiotherapy were stable or declining, but admission rates for chemotherapy and radiotherapy increased. The annual average cumulative length of stay decreased. Conclusions and implications: There has been a rapid increase in the number of prevalent patients requiring health care services for cancer during the 1990S. Most of the increase is due to improved survival, population growth and ageing. Further strain on Australian health care expenditure seems inevitable.