
Ontario Cancer Statistics 2022 Ch 5: Cancer Mortality
Mortality measures the number of deaths caused by cancer. This chapter presents actual (non-projected) cancer mortality rates and trends over time. These statistics are based on counts complete as of 2018, which is the latest available year.
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Cancer as a Leading Cause of Death
In 2018, cancer caused 27.7% of all deaths in Ontario, making it the province’s leading cause of death (Figure 5.1).[1] Cancer caused almost as many deaths as the next 3 leading causes of death combined: diseases of the heart, accidents and cerebrovascular diseases.
Probability of Dying From Cancer
The probability of dying from cancer represents the average chance of death due to cancer. This probability depends on many factors:
- population characteristics (e.g., demographics)
- prevalence of risk factors (e.g., smoking, obesity)
- availability and uptake of effective screening tests
- current life expectancy
- treatment options available
These probabilities also reflect the average risks for the overall population and do not take into account personal risk. In other words, an individual’s risk may be higher or lower than the numbers reported here.
In Ontario, 1 in 4, or 25.1% of people, will die from cancer (Table 5.1). Males have a greater chance of dying from cancer at slightly more than 1 in 4 (27.4%), compared with females at 1 in 4 (23.2%).
As with the chance of developing cancer, the probability of dying from cancer varies based on cancer type:
- Among males, the probability is highest for lung (1 in 16 males), prostate (1 in 29) and colorectal (1 in 32) cancers.
- Among females, the probability is highest for lung (1 in 19 females) breast (1 in 31) and colorectal (1 in 38) cancers.
Cancer type | Males and females combined % |
Males and females combined 1 in |
Males % |
Males 1 in |
Females % |
Females 1 in |
---|---|---|---|---|---|---|
All cancers | 25.1% | 4 | 27.4% | 4 | 23.2% | 4 |
Bladder | 0.9% | 116 | 1.3% | 77 | 0.5% | 210 |
Brain | 0.6% | 170 | 0.7% | 152 | 0.5% | 192 |
Breast (female) | n/a | n/a | n/a | n/a | 3.2% | 31 |
Cervix | n/a | n/a | n/a | n/a | 0.2% | 467 |
Colorectal | 2.9% | 35 | 3.1% | 32 | 2.7% | 38 |
Esophagus | 0.6% | 162 | 0.9% | 106 | 0.3% | 317 |
Hodgkin lymphoma | 0.0% | 2,845 | 0.0% | 2,373 | 0.0% | 3,512 |
Kidney | 0.5% | 192 | 0.7% | 150 | 0.4% | 261 |
Larynx | 0.1% | 923 | 0.2% | 537 | 0.0% | 2,750 |
Leukemia | 1.0% | 104 | 1.1% | 88 | 0.8% | 123 |
Liver | 0.9% | 107 | 1.2% | 84 | 0.7% | 146 |
Lung | 5.7% | 17 | 6.3% | 16 | 5.3% | 19 |
Melanoma | 0.4% | 242 | 0.6% | 180 | 0.3% | 351 |
Myeloma | 0.5% | 195 | 0.6% | 170 | 0.4% | 225 |
Non-Hodgkin lymphoma | 1.0% | 101 | 1.1% | 90 | 0.9% | 114 |
Oral cavity and pharynx | 0.4% | 247 | 0.5% | 182 | 0.3% | 376 |
Ovary | n/a | n/a | n/a | n/a | 1.1% | 95 |
Pancreas | 1.6% | 64 | 1.6% | 63 | 1.5% | 66 |
Prostate | n/a | n/a | 3.5% | 29 | n/a | n/a |
Stomach | 0.6% | 157 | 0.8% | 122 | 0.5% | 212 |
Testis | n/a | n/a | 0.0% | 6,011 | n/a | n/a |
Thyroid | 0.1% | 1,267 | 0.1% | 1,410 | 0.1% | 1,164 |
Uterus | n/a | n/a | n/a | n/a | 0.7% | 137 |
Abbreviation: n/a means not applicable.
Analysis by: Surveillance, Ontario Health (Cancer Care Ontario)
Data source: Ontario Cancer Registry (December 2020), Ontario Health (Cancer Care Ontario)
Mortality by Sex and Cancer Type
In 2018, 29,712 people died from cancer in Ontario, for an age-standardized mortality rate of 185.2 per 100,000 (Table 5.2).
Cancer type | Males and females combined Deaths |
Males and females combined % of deaths |
Males and females combined ASMR |
Males and females combined ASMR 95% CI |
Males Deaths |
Males % of deaths |
Males ASMR |
Males ASMR 95% CI |
Females Deaths |
Females % of deaths |
Females ASMR |
Females ASMR 95% CI |
---|---|---|---|---|---|---|---|---|---|---|---|---|
All cancers | 29,712 | 100.0% | 185.2 | 183.0-187.3 | 15,706 | 100.0% | 220.2 | 216.7-223.7 | 14,006 | 100.0% | 159.4 | 156.7-162.1 |
Bladder | 854 | 2.9% | 5.2 | 4.9-5.6 | 612 | 3.9% | 8.9 | 8.2-9.6 | 242 | 1.7% | 2.6 | 2.3-2.9 |
Brain | 844 | 2.8% | 5.4 | 5.1-5.8 | 470 | 3.0% | 6.5 | 5.9-7.1 | 374 | 2.7% | 4.5 | 4.0-5.0 |
Breast (female) | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 2,003 | 14.3% | 23.6 | 22.5-24.6 |
Cervix | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 145 | 1.0% | 1.9 | 1.6-2.2 |
Colorectal | 3,099 | 10.4% | 19.3 | 18.6-20.0 | 1,680 | 10.7% | 23.8 | 22.7-25.0 | 1,419 | 10.1% | 15.7 | 14.9-16.5 |
Esophagus | 847 | 2.9% | 5.3 | 4.9-5.7 | 635 | 4.0% | 8.7 | 8.1-9.4 | 212 | 1.5% | 2.4 | 2.1-2.8 |
Hodgkin lymphoma | 35 | 0.1% | 0.2 | 0.2-0.3 | 19 | 0.1% | 0.3 | 0.2-0.4 | 16 | 0.1% | 0.2 | 0.1-0.3 |
Kidney | 575 | 1.9% | 3.6 | 3.3-3.9 | 368 | 2.3% | 5.1 | 4.6-5.7 | 207 | 1.5% | 2.3 | 2.0-2.6 |
Larynx | 148 | 0.5% | 0.9 | 0.8-1.1 | 133 | 0.8% | 1.8 | 1.5-2.2 | 15 | 0.1% | 0.2 | 0.1-0.3 |
Leukemia | 1,077 | 3.6% | 6.7 | 6.3-7.1 | 609 | 3.9% | 8.6 | 7.9-9.3 | 468 | 3.3% | 5.2 | 4.7-5.7 |
Liver | 1,210 | 4.1% | 7.5 | 7.1-8.0 | 798 | 5.1% | 10.9 | 10.2-11.7 | 412 | 2.9% | 4.7 | 4.2-5.1 |
Lung | 6,971 | 23.5% | 43.1 | 42.1-44.2 | 3,712 | 23.6% | 51.1 | 49.5-52.8 | 3,259 | 23.3% | 37.1 | 35.8-38.4 |
Melanoma | 487 | 1.6% | 3.1 | 2.8-3.4 | 307 | 2.0% | 4.4 | 3.9-4.9 | 180 | 1.3% | 2.1 | 1.8-2.4 |
Myeloma | 586 | 2.0% | 3.6 | 3.3-3.9 | 329 | 2.1% | 4.6 | 4.2-5.2 | 257 | 1.8% | 2.8 | 2.5-3.2 |
Non-Hodgkin lymphoma | 1,137 | 3.8% | 7.1 | 6.7-7.5 | 644 | 4.1% | 9.1 | 8.4-9.8 | 493 | 3.5% | 5.5 | 5.1-6.1 |
Oral cavity and pharynx | 565 | 1.9% | 3.6 | 3.3-3.9 | 388 | 2.5% | 5.3 | 4.8-5.9 | 177 | 1.3% | 2.0 | 1.7-2.3 |
Ovary | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 677 | 4.8% | 7.9 | 7.4-8.6 |
Pancreas | 1,900 | 6.4% | 11.8 | 11.2-12.3 | 984 | 6.3% | 13.6 | 12.7-14.5 | 916 | 6.5% | 10.2 | 9.5-10.9 |
Prostate | n/a | n/a | n/a | n/a | 1,657 | 10.6% | 24.2 | 23.0-25.4 | n/a | n/a | n/a | n/a |
Stomach | 799 | 2.7% | 5.0 | 4.7-5.4 | 502 | 3.2% | 7.0 | 6.4-7.6 | 297 | 2.1% | 3.4 | 3.0-3.9 |
Testis | n/a | n/a | n/a | n/a | 22 | 0.1% | 0.3 | 0.2-0.5 | n/a | n/a | n/a | n/a |
Thyroid | 102 | 0.3% | 0.6 | 0.5-0.8 | 51 | 0.3% | 0.7 | 0.5-0.9 | 51 | 0.4% | 0.6 | 0.4-0.8 |
Uterus | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 495 | 3.5% | 5.7 | 5.2-6.2 |
Abbreviations: ASMR means age-standardized mortality rate; CI means confidence interval; n/a means not applicable.
Note: Rates are per 100,000 and standardized to the age distribution of the 2011 Canadian Standard population.
Analysis by: Surveillance, Ontario Health (Cancer Care Ontario)
Data source: Ontario Cancer Registry (December 2020), Ontario Health (Cancer Care Ontario)
The 4 most commonly diagnosed cancers (breast, colorectal, lung and prostate) were responsible for 46% of all cancer deaths in 2018. Lung, colorectal and prostate cancers accounted for 45% of all male cancer deaths, while lung, breast and colorectal cancers accounted for 48% of all female cancer deaths (Figure 5.2).
Some of the less commonly diagnosed cancers made a relatively large contribution to mortality because of their poor prognosis. For example, pancreatic cancer accounted for 6.4% of all cancer deaths in 2018, making it the third highest contributor to cancer deaths after lung and colorectal cancers (Table 5.2). By contrast, pancreatic cancer accounted for only 2.4% of new cases in the same year (see Chapter 4: Cancer Incidence).
The highest age-standardized mortality rates for cancers occurring in males and females combined were for lung (43.1 per 100,000), colorectal (19.3 per 100,000) and pancreas (11.8 per 100,000).
The age-standardized mortality rate for all cancers combined was significantly higher for males (220.2 per 100,000) than females (159.4 per 100,000). Among males, the highest age-standardized mortality rate was for lung (51.1 per 100,000), followed by colorectal (23.8 per 100,000) and prostate (24.2 per 100,000) cancers. For females, the highest age-standardized mortality rate was for lung (37.1 per 100,000), followed by breast (23.6 per 100,000) and colorectal (15.7 per 100,000) cancers.
Males had a consistently higher mortality rate than females for each type of cancer, except thyroid. Thyroid cancer mortality rates were similar for males and females.
The greatest differences between male and female cancer mortality rates were seen in:
- laryngeal cancer, which had a male rate that was 9 times higher than the female rate
- esophageal cancer, which had a male rate that was close to 4 times higher than the female rate
- bladder cancer, which had a male rate that was over 3 times higher than the female rate
- oral cavity and pharynx cancer, which had a male rate that was close to 3 times higher than the female rate
Tobacco use is a major risk factor for these 4 cancer types. The higher mortality rates in males likely result from their historically higher rates of tobacco use.[2]
Mortality by Age
From 2016 to 2018, the median age at death for all cancers was 74 for males and 75 for females (Table 5.3). The median age at death varied by cancer type. Cancers with the lowest median age at death were testicular and cervical. The median age for most other cancer types was over 70.
Cancer type | Age (years) Males and females combined |
Age (years) Males |
Age (years) Females |
---|---|---|---|
All cancers | 74 | 74 | 75 |
Bladder | 81 | 81 | 82 |
Brain | 67 | 65 | 68 |
Breast (female) | n/a | n/a | 71 |
Cervix | n/a | n/a | 61 |
Colorectal | 77 | 75 | 80 |
Esophagus | 71 | 70 | 75 |
Hodgkin lymphoma | 73 | 70 | 78 |
Kidney | 74 | 72 | 78 |
Larynx | 72 | 72 | 77 |
Leukemia | 77 | 76 | 78 |
Liver | 72 | 70 | 75 |
Lung | 74 | 74 | 74 |
Melanoma | 73 | 73 | 74 |
Myeloma | 77 | 76 | 78 |
Non-Hodgkin lymphoma | 76 | 75 | 77 |
Oral cavity and pharynx | 69 | 68 | 75 |
Ovary | n/a | n/a | 71 |
Pancreas | 74 | 72 | 75 |
Prostate | n/a | 82 | n/a |
Stomach | 73 | 72 | 74 |
Testis | n/a | 43 | n/a |
Thyroid | 73 | 69 | 79 |
Uterus | n/a | n/a | 72 |
Abbreviation: n/a means not applicable.
Analysis by: Surveillance, Ontario Health (Cancer Care Ontario)
Data source: Ontario Cancer Registry (December 2020), Ontario Health (Cancer Care Ontario)
In 2018, 86% of all people in Ontario who died of cancer were age 60 or older (Table 5.4). Mortality was distributed differently by age group.
Ages 0 to 39
People younger than age 40 made up 1.4% of all cancer deaths (compared with 5.1% of all new cases), with brain and breast cancers being the leading causes.
In 2018, 0.2% of all cancer deaths occurred in children with cancer (ages 0 to 14). From 1991 to 2019, the majority of deaths in children with cancer occurred in those with:
- central nervous system and miscellaneous intracranial and intraspinal neoplasms (36.5%)
- leukemias, myeloproliferative diseases and myelodysplastic diseases (25.9%)
For more information, please read the Pediatric Oncology Group of Ontario Surveillance Report.
Ages 40 to 59
People ages 40 to 59 made up 12.5% of all cancer deaths (compared with 22.7% of all new cases), with lung and breast cancers being the leading causes.
Ages 60 to 79
People ages 60 to 79 made up 50.3% of all cancer deaths (compared with 53.9% of all new cases).
This age group represented the greatest proportion of cancer deaths for 19 of the 23 types of cancer examined in this report. The greatest proportions of cancer deaths were from lung (27.8%) and colorectal (8.9%) cancers.
Ages 80 and older
People age 80 and older made up 35.8% of all cancer deaths (compared with 18.3% of all new cases), with lung and colorectal cancers as the leading causes.
While prostate cancer was diagnosed most frequently in males ages 60 to 79, most deaths caused by prostate cancer were in males age 80 and older. The higher mortality rate in males age 80 and older reflects the often slow progression of the disease and the higher frequency of later stage cancers in older males.
Cancer mortality increased significantly with age, from a rate of 6.1 per 100,000 in people age 39 or younger, to a rate of 1,702.4 per 100,000 in people age 80 or older (Table 5.4). Mortality varied by cancer type:
- There were significant increases in mortality with age for cancers of the bladder, breast, colorectum, kidney, stomach and thyroid, as well as leukemia, melanoma, Hodgkin lymphoma and non-Hodgkin lymphoma.
- There were non-significant increases in mortality with age for cancers of the brain, cervix, esophagus, larynx, liver, lung, oral cavity and pharynx, ovary, pancreas, prostate and uterus.
- Testicular cancer mortality was highest in people under age 60.
Cancer type | Ages 0 to 39 Deaths |
Ages 0 to 39 Age-specific rate |
Ages 0 to 39 95% CI |
Ages 40 to 59 Deaths |
Ages 40 to 59 Age-specific rate |
Ages 40 to 59 95% CI |
Ages 60 to 79 Deaths |
Ages 60 to 79 Age-specific rate |
Ages 60 to 79 95% CI |
80 years or older Deaths |
80 years or older Age-specific rate |
80 years or older 95% CI |
---|---|---|---|---|---|---|---|---|---|---|---|---|
All cancers* | 429 | 6.1 | 5.5-6.7 | 3,709 | 94.5 | 91.5-97.6 | 14,941 | 550.9 | 542.1-559.8 | 10,633 | 1702.4 | 1,670.2-1,735.1 |
Bladder* | ** | ** | ** | 50 | 1.3 | 0.9-1.7 | 340 | 12.5 | 11.2-13.9 | 465 | 74.5 | 67.8-81.5 |
Brain | 68 | 1 | 0.7-1.2 | 210 | 5.3 | 4.7-6.1 | 424 | 15.6 | 14.2-17.2 | 142 | 22.7 | 19.1-26.8 |
Breast (female)* | 58 | 1.7 | 1.3-2.2 | 447 | 22.4 | 20.4-24.6 | 858 | 60.4 | 56.4-64.6 | 640 | 170.3 | 157.3-184.0 |
Cervix | 11 | 0.3 | 0.2-0.6 | 60 | 3.0 | 2.3-3.9 | 45 | 3.2 | 2.3-4.2 | 29 | 7.7 | 5.2-11.1 |
Colorectal* | 38 | 0.5 | 0.4-0.7 | 387 | 9.9 | 8.9-10.9 | 1,327 | 48.9 | 46.3-51.6 | 1,347 | 215.7 | 204.3-227.5 |
Esophagus | ** | ** | ** | 130 | 3.3 | 2.8-3.9 | 482 | 17.8 | 16.2-19.4 | 231 | 37.0 | 32.4-42.1 |
Hodgkin lymphoma* | ** | ** | ** | ** | ** | ** | 19 | 0.7 | 0.4-1.1 | 7 | 1.1 | 0.5-2.3 |
Kidney* | ** | ** | ** | 80 | 2.0 | 1.6-2.5 | 286 | 10.5 | 9.4-11.8 | 207 | 33.1 | 28.8-38.0 |
Larynx | ** | ** | ** | 20 | 0.5 | 0.3-0.8 | 82 | 3.0 | 2.4-3.8 | 43 | 6.9 | 5.0-9.3 |
Leukemia* | 51 | 0.7 | 0.5-1.0 | 107 | 2.7 | 2.2-3.3 | 473 | 17.4 | 15.9-19.1 | 446 | 71.4 | 64.9-78.4 |
Liver | 10 | 0.1 | 0.1-0.3 | 153 | 3.9 | 3.3-4.6 | 704 | 26.0 | 24.1-27.9 | 343 | 54.9 | 49.3-61.0 |
Lung | 17 | 0.2 | 0.1-0.4 | 704 | 17.9 | 16.6-19.3 | 4,155 | 153.2 | 148.6-157.9 | 2,095 | 335.4 | 321.2-350.1 |
Melanoma* | 17 | 0.2 | 0.1-0.4 | 83 | 2.1 | 1.7-2.6 | 216 | 8.0 | 6.9-9.1 | 171 | 27.4 | 23.4-31.8 |
Myeloma | ** | ** | ** | 50 | 1.3 | 0.9-1.7 | 283 | 10.4 | 9.3-11.7 | 256 | 41.0 | 36.1-46.3 |
Non-Hodgkin lymphoma* | 15 | 0.2 | 0.1-0.4 | 114 | 2.9 | 2.4-3.5 | 547 | 20.2 | 18.5-21.9 | 461 | 73.8 | 67.2-80.9 |
Oral cavity and pharynx | 8 | 0.1 | 0.0-0.2 | 110 | 2.8 | 2.3-3.3 | 317 | 11.7 | 10.4-13.0 | 127 | 20.3 | 17.0-24.2 |
Ovary | 15 | 0.4 | 0.2-0.7 | 137 | 6.9 | 5.8-8.1 | 351 | 24.7 | 22.2-27.4 | 174 | 46.3 | 39.7-53.7 |
Pancreas | 7 | 0.1 | 0.0-0.2 | 212 | 5.4 | 4.7-6.2 | 1,052 | 38.8 | 36.5-41.2 | 629 | 100.7 | 93.0-108.9 |
Prostate | ** | ** | ** | 50 | 2.6 | 1.9-3.4 | 644 | 49.9 | 46.1-53.9 | 962 | 386.8 | 362.8-412.1 |
Stomach* | 13 | 0.2 | 0.1-0.3 | 122 | 3.1 | 2.6-3.7 | 421 | 15.5 | 14.1-17.1 | 243 | 38.9 | 34.2-44.1 |
Testis | 12 | 0.3 | 0.2-0.6 | 6 | 0.3 | 0.1-0.7 | ** | ** | ** | ** | ** | ** |
Thyroid* | ** | ** | ** | 20 | 0.5 | 0.3-0.8 | 53 | 2.0 | 1.5-2.6 | 33 | 5.3 | 3.6-7.4 |
Uterus | ** | ** | ** | 70 | 3.5 | 3.4-5.2 | 293 | 20.6 | 18.3-23.1 | 135 | 35.9 | 30.1-42.5 |
Abbreviation: CI means confidence interval.
Symbols:
*Significant increasing trend in age-specific rate with increasing age.
**Suppressed due to small case count (count less than 6).
†Count has been rounded to ensure confidentiality; the associated rate and confidence interval have been adjusted to reflect rounded count.
Notes:
- Rates are per 100,000.
- Excludes cases of unknown age.
Analysis by: Surveillance, Ontario Health (Cancer Care Ontario)
Data source: Ontario Cancer Registry (December 2020), Ontario Health (Cancer Care Ontario)
Mortality Trends by Cancer Type
This section describes annual percent changes in the age-standardized mortality rates, which are used to examine short-term changes in the trend in rates over time (Table 5.5).
The age-standardized mortality rate for all cancers combined in Ontario has been decreasing over the past few decades, with the drop in mortality accelerating in recent years. From 1984 to 2001, the age-standardized mortality rate decreased by 0.5% per year and fell a further 1.5% per year from 2001 to 2018.
The decrease in mortality was greater for males than females. For males, the mortality rate decreased by 1.0% per year from 1988 to 2001 and then by 1.7% per year from 2001 to 2018. For females, the rate decreased by 0.3% per year from 1984 to 2001 and then decreased by 1.3% per year from 2001 to 2018. This section examines some of the reasons for these changes in mortality trends.
Recent mortality trends for the 4 most common cancers
PROSTATE CANCER
The prostate cancer age-standardized mortality rate decreased by 2.9% per year from 1994 to 2014 and then stabilized from 2014 to 2018 (Table 5.5). This decrease was likely due to early detection and improved treatments, which have increased prostate cancer survival.[3]
BREAST CANCER
The age-standardized mortality rate for breast cancer decreased by 2.5% per year from 1994 to 2013 and was stable from 2013 to 2018 (Table 5.5). This decrease was likely due to:
- greater regular participation in mammography screening, especially after the introduction of Ontario’s organized breast screening program [4,5]
- improved treatment [6,7]
- the use of more effective systemic therapies following breast cancer surgery [6,7]
COLORECTAL CANCER
The colorectal cancer age-standardized mortality rate consistently decreased in males and females combined from 1984 to 2018, with the greatest decrease being in recent years (Table 5.5). The mortality rate decreased 3.1% per year from 2005 to 2018 among males and by 2.7% per year from 2004 to 2018 among females.
Reasons for this decrease in mortality may be changes in risk and protective factors, including earlier diagnosis due to greater uptake of screening and improvements in treatment.[8]
LUNG CANCER
In males, the age-standardized mortality rate for lung cancer decreased by 2.2% per year from 1989 to 2011, followed by a steeper decrease of 3.1% from 2011 to 2018 (Table 5.5). Among females, the mortality rate was stable from 1999 to 2010 and then began a decrease of 1.8% per year from 2010 to 2018.
The drop in lung cancer mortality is largely due to less tobacco use, which began to decrease in the late 1950s for males and in the mid-1970s for females.[2,9] This approximate 15-year gap in male and female peak smoking rates corresponds to the sex-based gap in the stabilization of lung cancer mortality rates.
Notable changes in trend for other cancers
LIVER CANCER
The liver cancer age-standardized mortality rate increased in all people from 1984 to 2018. The male rate increased by 2.2% per year from 1994 to 2018, following a previous rapid upward trend in the mortality rate (Table 5.5). The female mortality rate experienced a rapid increase from 2008 to 2013 before stabilizing from 2013 to 2018. This increase in mortality was probably at least partially due to a rise in incidence rate over the same period.
OVARIAN CANCER
The age-standardized mortality rate for ovarian cancer decreased significantly by 4.6% per year from 2003 to 2007 and then by 1.0% per year from 2007 to 2018 (Table 5.5). This pattern paralleled the decrease in the ovarian cancer incidence rate from 2002 to 2018.
Drops in ovarian cancer incidence and mortality likely resulted from changes in exposure to risk and protective factors, including the increasing use of oral contraceptives.[10] Drops in mortality may also reflect increasing survival due to improvements in treatment for this cancer.[11]
STOMACH CANCER
The stomach cancer age-standardized mortality rate decreased by 4.0% per year until 1993 and then by 2.2% per year from 1993 to 2018 (Table 5.5).
Reasons for this decrease include less exposure to Helicobacter pylori infection, improvements in food preservation and refrigeration, lifestyle changes and better treatment for this cancer.[12]
Cancer type | Males and females combined Period |
Males and females combined APC (%) |
Males Period |
Males APC (%) |
Females Period |
Females APC (%) |
---|---|---|---|---|---|---|
All cancers | 1984-2001 | -0.5* | 1984-1988 | 0.5 | 1984-2001 | -0.3* |
2001-2018 | -1.5* | 1988-2001 | -1* | 2001-2018 | -1.3* | |
2001-2018 | -1.7* | |||||
Bladder | 1984-2018 | -0.5* | 1984-2018 | -0.7* | 1984-1997 | -1.5* |
1997-2004 | 2.2 | |||||
2004-2018 | -1.7* | |||||
Brain | 1984-2006 | -1.1* | 1984-1995 | -1.9* | 1984-2006 | -1.4* |
2006-2010 | 4.8 | 1995-2018 | 0.4 | 2006-2011 | 4.6 | |
2010-2018 | -1 | 2011-2018 | -1.3 | |||
Breast (female) | n/a | n/a | n/a | n/a | 1984-1994 | -0.8* |
n/a | n/a | n/a | n/a | 1994-2013 | -2.5* | |
n/a | n/a | n/a | n/a | 2013-2018 | -0.7 | |
Cervix | n/a | n/a | n/a | n/a | 1984-2018 | -2.6* |
Colorectal | 1984-2005 | -1.6* | 1984-2005 | -1.5* | 1984-2004 | -1.8* |
2005-2018 | -2.9* | 2005-2018 | -3.1* | 2004-2018 | -2.7* | |
Esophagus | 1984-2000 | 0.5 | 1984-2001 | 0.8* | 1984-2018 | -0.9* |
2000-2018 | -0.6* | 2001-2018 | -0.7* | |||
Hodgkin lymphoma | 1984-2018 | -3.4* | 1984-2018 | -3.5* | 1984-2018 | -3.3* |
Kidney | 1984-2008 | -0.1 | 1984-2014 | -0.3* | 1984-2010 | -0.3 |
2008-2018 | -1.9* | 2014-2018 | -4.8* | 2010-2018 | -2.9* | |
Larynx | 1984-1988 | 3.2 | 1984-2001 | -2* | 1984-2018 | -3.2* |
1988-2001 | -2.5* | 2001-2018 | -4.5* | |||
2001-2018 | -4.2* | |||||
Leukemia | 1984-2018 | -0.9* | 1984-2018 | -1* | 1984-2018 | -1* |
Liver | 1984-1994 | 4.7* | 1984-1995 | 4.6* | 1984-1991 | 6.3* |
1994-2008 | 1.8* | 1995-2018 | 2.2* | 1991-2008 | 1.4* | |
2008-2012 | 5.6 | 2008-2013 | 6.6* | |||
2012-2018 | 0.5 | 2013-2018 | -0.4 | |||
Lung | 1984-1993 | 0.1 | 1984-1989 | -0.3 | 1984-1999 | 2* |
1993-2010 | -1* | 1989-2011 | -2.2* | 1999-2010 | -0.1 | |
2010-2018 | -2.4* | 2011-2018 | -3.1* | 2010-2018 | -1.8* | |
Melanoma | 1984-2014 | 1* | 1984-2014 | 1.3* | 1984-1995 | 2.1* |
2014-2018 | -4 | 2014-2018 | -4.7 | 1995-2018 | -0.2 | |
Myeloma | 1984-1998 | 0.4 | 1984-2018 | -0.7* | 1984-1999 | 0.4 |
1998-2018 | -1.2* | 1999-2018 | -1.6* | |||
Non-Hodgkin lymphoma | 1984-1998 | 2.2* | 1984-1999 | 2* | 1984-1997 | 2.5* |
1998-2018 | -1.8* | 1999-2018 | -1.7* | 1997-2018 | -2* | |
Oral cavity and pharynx | 1984-2009 | -1.9* | 1984-2007 | -2.3* | 1984-2012 | -1.6* |
2009-2018 | 1.7* | 2007-2018 | 1.2* | 2012-2018 | 2.8 | |
Ovary | n/a | n/a | n/a | n/a | 1984-1999 | -0.9* |
n/a | n/a | n/a | n/a | 1999-2003 | 2.2 | |
n/a | n/a | n/a | n/a | 2003-2007 | -4.6* | |
n/a | n/a | n/a | n/a | 2007-2018 | -1* | |
Pancreas | 1984-2002 | -0.8* | 1984-2005 | -1.2* | 1984-2018 | -0.1 |
2002-2018 | 0.4* | 2005-2018 | 1* | |||
Prostate | n/a | n/a | 1984-1994 | 1.5* | n/a | n/a |
n/a | n/a | 1994-2014 | -2.9* | |||
n/a | n/a | 2014-2018 | -1 | n/a | n/a | |
Stomach | 1984-1993 | -4* | 1984-1993 | -4.1* | 1984-1997 | -3.5* |
1993-2018 | -2.2* | 1993-2018 | -2.5* | 1997-2018 | -1.8* | |
Testis | n/a | n/a | 1984-2018 | -2.3* | n/a | n/a |
Thyroid | 1984-2018 | -0.1 | 1984-2018 | 0.9* | 1984-2018 | -0.7* |
Uterus | n/a | n/a | n/a | n/a | 1984-1993 | -1.7 |
n/a | n/a | n/a | n/a | 1993-2018 | 1.2* |
Abbreviations: APC means annual percent change; n/a means not applicable.
Symbol: *Statistically significant trend.
Note: Rates are standardized to the 2011 Canadian Standard population
Analysis by: Surveillance, Ontario Health (Cancer Care Ontario)
Data source: Ontario Cancer Registry (December 2020), Ontario Health (Cancer Care Ontario)
Thirty-five year trend in mortality by cancer type
The age-standardized mortality rate from 1984 to 2018 for breast, colorectal, lung, oral cavity and pharynx, pancreatic, prostate and uterus cancers are shown in Figure 5.3. These cancers represent the 4 most common cancers, plus those with an increasing trend in mortality in recent years.
From 1984 to 2018, the average annual percent change in the age-standardized mortality rate for males (Figure 5.4):
- decreased for most types of cancer, including Hodgkin lymphoma (3.5% per year), laryngeal cancer (3.2%) and stomach cancer (2.9%)
- increased for liver cancer (2.9% per year) and thyroid cancer (0.9% per year)
- was stable for brain and esophageal cancers, as well as melanoma and non-Hodgkin lymphoma
Over the same period, the average annual percent change in the age-standardized mortality rate for females:
- decreased for most types of cancer, including Hodgkin lymphoma (3.3% per year), and cervical (2.6%) and laryngeal (3.2%) cancers
- increased for liver (2.9% per year) and lung (0.5%) cancers
- was stable for bladder, brain, oral cavity and pharynx, pancreatic and uterine cancers, as well as non-Hodgkin lymphoma and melanoma
For some cancers, such as liver cancer and melanoma, the increases in mortality rates likely reflect increases in incidence rates.
Mortality Trends by Age
Mortality rates across all age groups have been decreasing in recent decades. In younger people, they have decreased fairly equally for males and females. However, among people age 60 and older, the decreases in mortality have been greater among males (Figure 5.5).
Ages 0 to 39
While incidence rates have been increasing among younger people, mortality rates have been stable or decreasing. Among males under 40, the mortality rate decreased by 1.6% per year from 1984 to 2018. Among females in this age group, mortality rates decreased by 1.9% per year from 1984 to 2006, and were stable from 2006 to 2018.
Age-standardized mortality rates among children with cancer (ages 0 to 14) decreased from 1991 to 2019 by an average of 1.2% per year (see Spotlight: Childhood Cancer Mortality Trend, Figure 5.S1).
Spotlight: Childhood Cancer Mortality Trends
For more details on childhood cancer mortality trends, read the Pediatric Oncology Group of Ontario Surveillance Report.
Ages 40 to 59
For people ages 40 to 59, the mortality rate was stable until 1989, when it started to decrease by 2.1% per year until 2018. Similar trends were seen separately for males and for females.
Ages 60 to 79
Among people ages 60 to 79, the mortality rate was stable until 1988. The mortality rate then decreased by 0.7% per year from 1988 to 2001 and by 1.9% per year from 2001 to 2018. The rate of decrease in the most recent decades has been greater for males (2.3% per year from 2001 to 2014 and 1.4% per year from 2014 to 2018) than females (1.7% per year from 2002 to 2018).
Ages 80 and older
Mortality among people age 80 and older increased by 0.5% per year from 1984 to 2001 and then decreased by 0.5% per year from 2001 to 2018. The decrease in mortality was greater for males, at 1.0% per year from 2001 to 2018. Among females, the mortality rate increased by 1.3% from 1992 to 2001 and then decreased by 0.5% per year.