Incidence

2022 estimates

In 2022, an estimated 95,325 new cancer cases are expected to be diagnosed in Ontario (or about 261 new cancer cases diagnosed every day). (Chapter 1)

• The age-standardized cancer incidence rate is estimated to be 556.3 cases per 100,000 and is higher in males (603.6 per 100,000) than females (521.4 per 100,000).
• The most commonly diagnosed cancers will be breast (12,531), followed by lung (10,639) and prostate (10,578) cancers.
• The greatest number of new cancer cases will occur in people ages 60 to 79, with this age group accounting for more than half (56%) of all cancers.

Trends over time

Cancer incidence rates in recent years stabilized in men after over a decade of decline, and stabilized in women and children (ages 0 to 14) after several years of increase. (Chapter 4)

• The overall incidence rate in adults decreased by 1.4% per year from 2007 to 2014, but stabilized in the following years from 2014 to 2018.
  • The biggest driver for the overall decrease in incidence rate prior to 2014 was the decrease in incidence rate for males (of 2.8% per year from 2007 to 2014), which has since plateaued.
• There were notable changes for specific cancers:
  • The female lung cancer incidence rate showed a statistically significant decrease of 1.0% per year from 2012 to 2018. This decreasing rate reversed a period of increase and is contributing to the recent stable overall incidence rate in females.
    • The decreasing lung cancer incidence trend in females mirrored the decreasing trend seen in males.
    • The male incidence rate showed 2 periods of decline since 1990, with the most recent decrease occurring from 2012 to 2018 (2.9% per year) for all histological subtypes.
  • Following 2 decades of decline, the cervical cancer incidence rate was stable from 2006 to 2018, showing no significant upward or downward trend.
  • Following 3 decades of increase, the thyroid cancer incidence rate has decreased from 2013 to 2018 (4.1% per year), largely due to the declining trend in papillary thyroid cancer.
  • Following 3 decades of stable trends, leukemia incidence rates began decreasing in about 2007, driven largely by a decrease in chronic lymphocytic leukemia. However, other leukemias examined in this report continued their upward trend.
  • A steady increase in all lymphomas plateaued from 2013 to 2018, mirroring the trend in non-Hodgkin lymphoma.
  • Myeloma incidence increased in females at a rate of 2.6% per from 2008 to 2018.
  • The greatest decreases in incidence rates from 1984 to 2018 were in brain, colorectal, esophagus (mainly squamous cell), laryngeal, bladder and stomach cancers.
  • The greatest increases in incidence rates from 1984 to 2018 were in liver, kidney and uterine (mainly endometrial) cancers, as well as melanoma.
• Based on data from the Pediatric Oncology Group of Ontario Networked Information System, the overall trend in childhood cancer incidence rates from 1986 to 2020 was stable, which was helped by stable rates in recent years slowing the previously increasing trend.
  • The childhood cancer incidence rate increased by 1.7% per year from 2002 to 2015, but stabilized from 2015 to 2020.

Notable patterns

Approximately 1 in 2 people in Ontario is expected to be diagnosed with cancer in their lifetime. The probability of developing cancer is similar for males and females. (Chapter 4)

• Among males, the probability is highest for prostate (1 in 9), lung (1 in 17) and colorectal (1 in 20) cancers.
• Among females, the probability is highest for breast (1 in 9), lung (1 in 18) and colorectal (1 in 23) cancers.

Lung, colorectal, breast (female) and prostate cancers were responsible for almost 50% of the 84,816 new cancer cases diagnosed in 2018. (Chapter 4)

In 2018, the median age at cancer diagnosis was slightly higher for males at age 68 than for females at age 66. (Chapter 4)

Since about 2007, incidence rates generally decreased among people age 40 and older while they stabilized in younger people after a long period of increase. (Chapter 4)

• Until 2011, the overall incidence rate in people under age 40 was increasing but has been stable from 2011 to 2018.
• Young women are at higher risk for certain cancers. Among people in Ontario under age 40, females have a higher incidence rate than males for all cancers combined, mainly due to the high incidence of breast and thyroid cancers for females in this age group.

The detection of cancers at an earlier, more favourable stage for treatment has improved over time for some common cancers, but not for others. (Chapter 4)

• The stage distribution for lung cancer improved over time, with a lower proportion of cases seen at stage 4 in 2017 (47%) compared with 2010 (57%), and a higher proportion at stage 1.
• The stage distribution for cervical cancer got worse, with a higher proportion of cases seen at stage 2 than at stage 1 in 2017 (18%) compared with 2010 (9%).

Mortality

Current estimates

In 2022, an estimated 31,196 deaths from cancer are expected in Ontario (or about 85 cancer deaths every day). (Chapter 2)

• The age-standardized mortality rate is estimated to be 174.9 deaths per 100,000 and is higher in males (204.0 per 100,000) than females (152.7 per 100,000).
• Almost one-quarter of all cancer deaths will be due to lung cancer (6,908), followed by colorectal (3,226), pancreatic (2,156) and breast cancers (2,114).
• More than half of all cancer deaths in 2022 (52%) are expected to occur in people ages 60 to 79, and more than one-third are expected to occur in people age 80 and older.

Trends over time

Death rates for all cancers combined continued to decrease in Ontario’s men, women and children. The decrease in men and women accelerated in recent years. (Chapter 5)

• The overall cancer death rate in Ontario peaked in 1988 and decreased every year up to 2018.
• Among adults, the death rate for males decreased by 1.7% per year and for females by 1.3% per year from 2001 to 2018. These drops were driven largely by lung cancer, but also by other common cancers such as breast, prostate and colorectal.
• Based on data from the Pediatric Oncology Group of Ontario Networked Information System, the childhood cancer mortality rate decreased by an average of 1.2% per year from 1991 to 2019.

Notable patterns

Approximately 1 in 4 people in Ontario is expected to die of cancer. Males have a slightly greater chance of dying (27.4%) than females (23.2%). (Chapter 5)

• Among males, the probability is highest for lung (1 in 16), prostate (1 in 29) and colorectal (1 in 32) cancers.
• Among females, the probability is highest for lung (1 in 19), breast (1 in 31) and colorectal (1 in 38) cancers.

Cancer was responsible for 27.7% of all deaths in Ontario in 2018, making it the province’s leading cause of death. (Chapter 5)

• Lung, colorectal, breast and prostate cancers were responsible for 46% of the 29,712 cancer deaths in 2018.
• Although pancreatic cancer is less common, it accounted for 6.4% of cancer deaths.

In 2018, the median age of cancer death was 74 for males and 75 for females. (Chapter 5)

• Of all cancer deaths in Ontario, 86% were in people age 60 or older.

Despite an overall decrease, death rates are on the rise for certain cancers. (Chapter 5)

• In recent years, cancer death rates increased for thyroid cancer (males), oral cavity and pharynx (males), pancreatic (males) and uterine cancers.

Survival

Recent estimates

The 5-year survival for all cancers combined continued to improve over time. (Chapter 6)

• In people ages 15 to 99, the overall 5-year relative survival ratio was 67.2% for the 2014 to 2018 period, which is higher than previous periods. During this recent period, females experienced a higher 5-year survival than males (69.1% versus 65.3%).
• In general, the 5-year relative survival ratio for all cancers combined decreases with advancing age at diagnosis. During the 2014 to 2018 period, 5-year survival ranged from 88.7% for people diagnosed at ages 15 to 39, to 44.9% for people diagnosed at ages 80 to 99.
• The overall 5-year observed survival proportion for childhood cancer increased by 6.4 percentage points, from 76.9% for the 1990 to 1994 period to 83.3% for the 2015 to 2019 period.

There is large variation in 5-year relative survival by cancer type. (Chapter 6)

• In people ages 15 to 99, thyroid (98.9%), testicular (97.1%) and prostate (94.0%) cancers had the highest survival for the 2014 to 2018 period.
• Over the same period, pancreatic (12.6%), esophageal (17.3%), lung (24.8%) and liver (22.8%) cancers had the lowest survival.

Trends over time

Although survival for all cancers combined improved, the rate of improvement has slowed over time. (Chapter 6)

• A 7.4 percentage point increase in 5-year relative survival for all cancers combined was seen from the 1984 to 1988 period to the 1994 to 1998 period.
• The improvements in survival decreased in subsequent decades, with the 5-year relative survival for all cancers increasing by 6.6 percentage points from the 1994 to 1998 period to the 2004 to 2008 period and by just 2.5 percentage points from the 2004 to 2008 period to the 2014 to 2018 period.

From the 1984 to 1988 period to the 2014 to 2018 period, people diagnosed at ages 40 to 79 showed the greatest improvements in 5-year relative survival. (Chapter 6)

• People diagnosed at age 80 or older were the only age group that showed no significant improvement in 5-year relative survival over the same period.

Notable patterns

Survival improved at a faster pace for certain cancers from 1984 to 2018. (Chapter 6)

• Compared with other cancers, the 5-year relative survival ratio improved the most for hematological cancers from the 1984 to 1988 period to the 2014 to 2018 period. Leukemia survival increased by about 25 percentage points and myeloma by 26 percentage points.
• Kidney cancer also experienced a 25 percentage point increase.
• The 5-year relative survival ratio decreased the most for bladder cancer by about 11 percentage points.

Survival depends on stage at diagnosis. (Chapter 6)

• For the 4 most common cancers, the greatest drop in 5-year survival occurred with the progression from stage 3 to stage 4.
• This drop ranged from a 14.6 percentage point difference for lung cancer to a 56.8 percentage point difference for colorectal cancer.

Prevalence

Recent estimates

There are now more cancer survivors in Ontario than ever before. With increasing incidence and improving survival, the prevalence of cancer cases has also increased over time. Prevalent cases include newly diagnosed people with cancer, as well as people who were previously diagnosed with cancer and who are still alive. (Chapter 7)

• At the end of 2018, there were more than a half a million people in Ontario (an estimated 676,509) who had a cancer diagnosed in the previous 30 years and who were still alive. Of those, 411,158 were diagnosed in the last 10 years alone.
• More females than males are long-term survivors of cancer. In particular, females with breast cancer represent the largest group, accounting for 78,182 of prevalent cases diagnosed in the most recent decade, from 2009 to 2018.

Trends over time

The prevalence proportion increased over time for most cancers, but it changed very little or decreased for others. (Chapter 7)

• Among major cancer types, the 10-year prevalence proportion for people diagnosed with Hodgkin lymphoma changed very little from 2008 to 2018.
• From 1998 to 2018, the 10-year prevalence proportion for people diagnosed with larynx, bladder and cervical cancers decreased.

Future estimates

The number of prevalent cases will continue to increase in the future for many cancers. Prevalent cases include newly diagnosed people with cancer, as well as people who were previously diagnosed with cancer and who are still alive. (Chapter 3)

• The prevalence of cancer is projected to increase by about 50% from an estimated 845,188 people in 2019 to 1,265,216 in 2034.
• While the counts will increase in both males and females, the projected rates will differ between them. The projected prevalence proportion will continue to increase in females, but the rate in males is expected to rise in the short-term before decreasing in the longer-term.
• Given the relative changes in rates, by 2034, thyroid, kidney and uterine cancers are expected to represent a larger proportion of prevalent cancer cases.
• The anticipated change in prevalent cases will vary by age group over time, with the relative proportion of cases increasing most for people age 80 and older and decreasing most for people age 40 to 59.
• Estimating the future prevalence of cancer can help health planners, policy-makers and healthcare service providers anticipate the health system resources and costs that are needed to care for people newly diagnosed with cancer and provide ongoing care to cancer survivors.

Back
to Top