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Increasing Burden of Cancer and Cardiovascular Disease in Australia - Ageing as a potentially reversible risk factor

Harry Wu, David Le Couteur, John Mach and Sarah Hilmer

Kolling Institute of Medical Research, University of Sydney and Royal North Shore Hospital, Sydney, New South Wales, Australia

Background

In recent decades, there have been remarkable scientific discoveries in the field of Geroscience and longevity research. Age is the primary risk factor for the majority of chronic diseases. We aimed to quantify Australian nationwide trends of prescription and hospitalisation rates for cancer and cardiovascular diseases over a 24-year period (July 1993–June 2017). We characterised the impact of age on rates of hospitalisations.


Methods

Prescription data were obtained from publicly available Pharmaceutical Benefit Scheme database. Hospitalisations with principle diagnoses of cancer or cardiovascular disease were extracted from Australian Institute of Health and Welfare National Hospital Morbidity Database. Australian population estimates were obtained from Australian Bureau of Statistics. Age specific incidence rate ratios (IRR) were assessed using negative binomial regression models.


Results

Between July 1993 and June 2017, hospitalisations due to cancer and cardiovascular disease increased from 301,925 to 684,075 and 372,858 to 576,515 respectively. Population-adjusted hospitalisations rates for cancer and cardiovascular disease increased by 64.0% and 11.9% respectively. For every 10-year increase in age, the rate of hospitalisation due to cardiovascular disease increased by 102.7% ([IRR]=2.027; 95%CI=2.010-2.044;p<0.001). Hospitalisation rate for cancer increased by 67.1% per decade of life ([IRR]=1.671; 95%CI=1.655-1.687;p<0.001). Over the 24-years, cancer prescriptions increased almost 10-fold from 491,361 to 4,132,703. Cardiovascular prescriptions increased 3-4 fold from 27,176,141 to 90,447,071. Cancer and cardiovascular prescription rates (per thousand population) increased from 27.6 to 168.0 and 1526.3 to 3676.4, respectively. Annual expenditure for these medications increased from $0.619 billion to $4.76 billion over the study period.


Conclusions

Age is a strong risk factor for hospitalisations due to cancer and cardiovascular disease. Prescription and hospitalisation rates due to these conditions continue to rise with significant healthcare costs. There is a growing need to develop treatment strategies that target fundamental mechanisms of ageing to reduce the burden of age-related diseases.