Background In 2017, the New South Wales Cancer Registry (NSWCR) participated in a project, supported by Cancer Australia, aiming to provide national stage data for melanoma, prostate, colorectal, breast, and lung cancers diagnosed in 2011. Simplified business rules based on the American Joint Committee for Cancer (AJCC) Tumour-Node-Metastasis (TNM) stage were applied to obtain Registry-Derived (RD) stage, defined as the best estimate of TNM stage at diagnosis using routine notifications available within cancer registries. RD-stage was compared with Degree of Spread (DoS), which has been recorded for all applicable cancers in NSWCR at a population-based level since 1972, and a summary AJCC-TNM stage group, which has been collected variably since 2006. For each of the five high incidence cancers, we compared the level of improvements RD-staging provided in terms of completeness and accuracy (alignment to more clinically relevant AJCC-TNM) over DoS. Methods For each of the five cancers, stage data were extracted from NSWCR pre- and post- RD-staging to compare data completeness across all three staging systems. The alignment between DoS/RD-stage and AJCC-TNM was compared, as were the expected and observed cross-tabulated frequency distributions using a subset of NSWCR data. To determine differences between use of DoS, RD-stage, and AJCC-TNM in an epidemiological analysis, we compared survival models developed from each of the three stage variables. Results We found RD-staging provided greatest stage data completeness and alignment to AJCC-TNM for prostate cancers, followed by breast, then melanoma and lung cancers. For colorectal cancer, summary stage from DoS was confirmed as an equivalent surrogate staging system to both AJCC-TNM and RD-stage. Conclusions This analysis provides an evidence-based approach that can be used to inform decision-making for resource planning and potential implementation of a new stage data field in population-based cancer registries. Electronic supplementary material The online version of this article (10.1186/s12885-019-6062-x) contains supplementary material, which is available to authorized users.

Previously published sub-site Australian projections for colon and rectal cancers to 2035 using the World Health Organization’s mortality database sourced from the Australian Bureau of Statistics (ABS) predicted mortality rate decreases for colon cancer and increases for rectal cancer. There are complexities related to the interpretation of ABS’s Australian colon and rectal cancer mortality rates, which could lead to possible inaccuracies in mortality rates for these sub-sites. The largest Australian population-wide registry, New South Wales Cancer Registry (NSWCR), compares routinely-reported causes of death with the recorded medical history from multiple data sources. Therefore, this study used the NSWCR data to project mortality rates for colon and rectal cancers separately to 2040 in Australia. The mortality rates for colon cancer are projected to continuously decline over the period 2015–2040, from 7.0 to 4.7 per 100,000 males, and from 5.3 to 3.2 per 100,000 females. Similar decreasing trends in mortality rates for rectal cancer were projected over the period 2015–2040, from 4.9 to 3.7 per 100,000 males, and from 2.6 to 2.3 per 100,000 females. These projections provide benchmark estimates for the colorectal cancer burden in Australia against which the effectiveness of cancer control interventions can be measured.

IntroductionAustralia has one of the highest rates of malignant mesothelioma in the world, a legacy of the widespread use of asbestos for several decades until the 1980s.MethodsIn 2011, the Commonwealth Government commissioned a registry to provide on-going information on the incidence, mortality, case characteristics and exposure history of persons diagnosed with mesothelioma in Australia. Notifications come from state and territory cancer registries. Information on occupational and non-occupational asbestos exposure involves a self-completed questionnaire and a structured telephone interview using OccIDEAS, a computer-based exposure assessment system, and overseen by a research team at Monash University. The latest public data is current to 31 December 2014.ResultsIn 2014, there were 641 new notifications (607 deaths) of persons diagnosed with mesothelioma – 81% male, 85% aged 65 years or older (47% 75 years or older), 93% pleural, age standardised rate = 2.8/100,000. Using historical data, the peak incidence appears to have occurred around 2003 (3.2/100,000), although the number of cases appears to have peaked in the last few years.Detailed exposure information was available for 449 people diagnosed from 1 July 2010. Key findings included possible or probable asbestos exposure above background levels in the following circumstances – occupational only (11%), non-occupational only (35%), both (49%), neither (5%). Occupational exposure was most common in construction workers, electricians and boilermakers/welders. The most common sources of non-occupational exposure were servicing cars in a non-occupational setting, home renovation and living with someone with an asbestos-exposed job.Discussion and conclusionResults confirm the high frequency and rate of mesothelioma in Australia and identify common sources of occupational and non-occupational asbestos exposure. Methodological and practical challenges to the running of the Registry include delays in notification and delays in providing consent for contact for exposure assessment (but participation is high once contact is made).