By 2050, more than one million Australians aged 80 and over will account for almost 40% of all cancer survivors. Is Australia’s health system prepared?
Australia’s cancer care system will need to adapt to a future in which millions of people live for years with or beyond cancer, with the number of Australians affected projected to climb almost 60% by 2050.
The first long-term projections of cancer prevalence in Australia estimate that 2.62 million people will be living with a previous cancer diagnosis in 2050, up from 1.67 million.
But study co-author Professor Michael Jefford, a senior medical oncologist and director of the Australian Cancer Survivorship Centre at Peter MacCallum Cancer Centre in Melbourne, said the headline figure concealed an important challenge for the health system – many of those people would still have active, incurable disease.
The researchers estimated that while 1.47 million people with a history of cancer may potentially be cured by 2050, around 1.15 million – or 44% – would be living with incurable cancer and potentially requiring ongoing treatment.
That treatment will require an appropriate workforce.
“We already knew that the number of [cancer] cases would increase… and we’ve known that survival rates are increasing,” Professor Jefford told Oncology Republic.
However, the data revealed that many survivors may be living with treatable but not curable cancers, such as metastatic melanoma or advanced lung cancer, and would require ongoing longer-term treatment, Professor Jefford said.
He said the projections helped expose the scale of the population likely to be living long term with treatable but incurable cancers, such as metastatic melanoma or advanced lung cancer.
“Instead of having to treat people for a month or two, if they’re on treatment for four, five, or ten years, that clearly has huge impacts because they’re still going to the hospital and having treatment, but they’re also going to their GP,” he said.
The study, published in The Lancet Regional Health Western Pacific, examined 24 cancer types and all cancers combined over the previous 30 years following an initial diagnosis.
Australia’s population, roughly 27 million according to the ABS, is forecast to grow to between 32.5 and 38 million by 2050, depending on immigration, fertility rates and life expectancy. This population growth was expected to drive the increase.
Breast cancer was projected to be Australia’s most prevalent cancer in 2050, with an estimated 485,135 cases, followed by prostate cancer with 468,991 cases – both expected to increase by more than 50% from 2025.
Melanoma was next, forecast to reach 331,909 cases – a 32.8% increase from 2025 – while colorectal cases were estimated to rise 36.2% to 237,053. Kidney cancer diagnoses were also set to soar by 112%, to a total of 108,101 cases by 2050.
Testicular (84.4%), thyroid (79.4%), prostate (75.9%), breast (72.5%) and melanoma (69.8%) were predicted to have the highest proportions of people living beyond cancer – potentially cured – by 2050.
More male than female survivors were projected, which researchers attributed to consistently higher cancer rates in men than women.
The study estimated most people living with or beyond cancer in 2050 would be long-term survivors, with 69.8% diagnosed at least five years earlier.
Lead author Associate Professor Qingwei Luo, an epidemiologist at the Daffodil Centre, a partnership between Cancer Council NSW and the University of Sydney, said the analysis highlighted the challenge not only of treating people with cancer but of ensuring a growing, increasingly diverse population could live well for years after diagnosis.
“This fundamentally changes what cancer care needs to deliver, because a history of a past cancer diagnosis and treatment will increasingly become part of everyday chronic disease management,” she said.
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She attributed the rise in people living with or beyond cancer to the growing, aging population and successful early detection and treatment initiatives, while noting ongoing challenges posed by preventable risk factors.
While people aged 70 to 79 years were estimated to constitute the largest proportion across all prevalence durations in 2025, this was projected to shift to those aged 80 and over by 2050.
Researchers expect this cohort to more than double, from over 481,000 in 2025 to more than one million by 2050.
Researchers noted the increase in middle and older-aged groups living with cancer would have critical implications for the healthcare system, as around one in five Australians aged 65 and over had severe or profound comorbid illnesses.
Common coexisting conditions, such as coronary artery disease, dementia and chronic obstructive pulmonary disease, would drive rising multimorbidity, requiring better-coordinated care across the health system, the researchers said.
Professor Luo said that approximately one-third of cancers relate to modifiable risk factors, reinforcing the importance of addressing major lifestyle changes and health promotion, not just early detection.
Importantly, she said prevention was not just an individual responsibility but a shared role among governments, health services, employers, and communities to create environments that support healthy choices.
“Primary care practitioners can advise patients on smoking cessation, maintaining a healthy body weight and dietary patterns, being physically active, protecting against excessive sun exposure, and limiting alcohol consumption,” she said.
Alongside primary prevention, Professor Luo said population screening remained “one of the most powerful tools” to reduce future cancer burden, reaffirming the need to boost screening participation through risk-stratified approaches that ensure higher-risk individuals receive more tailored care.
“Screening can enable cancers to be detected at an earlier stage, when treatment is often more effective, less intensive, and associated with better outcomes,” she said.
“In addition, we need to invest in the cancer workforce.”
The ongoing need for long-term monitoring in a “people-intensive service” would likely require greater investment in rehabilitation, supportive care, mental health services, and integrated specialist-primary care models, which may help reduce potentially preventable hospital use, she said.
“Another key pressure point is coordinating care for people living with cancer alongside other chronic conditions,” Professor Luo said.
While demand for oncology services would rise, she said practitioners could expect growing demand for follow-up and survivorship care, likely requiring longer, more complex consultations.
She said careful workforce planning would be needed to address the “significant pressure” on the oncology workforce.
“The decisions we make today will determine whether the growing number of cancer survivors becomes a strain on the health system or one of the great public health success stories of the coming decades,” she said.
The challenge, Professsor Luo told OR, was ensuring these investments were made early enough to meet future demand.
“The future burden of cancer will be influenced by public health policies, social determinants of health, and medical advances,” she said.
This highlighted the need for sustainable workforce capacity, both to deliver active treatment and to provide close surveillance for those in remission.
Professor Jefford acknowledged that “blanket treatment” would be inappropriate, but there was evidence that GP-led follow-up was at least as effective as oncologist-led care, particularly in coordinating and managing the whole person.
He said this was especially important for supporting patients who had finished treatment but were experiencing pain, fatigue, psychological stress, difficulty reintegrating into their daily routine, or loss of income.
In studies conducted by Professor Jefford, GPs were more competent than hospital providers at performing routine surveillance blood tests, including PSA and CEA tests, he told OR.
“A lot of survivorship care, including health promotion, ensuring people continue to have screening for other health conditions and cancers, and addressing health risk factors such as smoking, exercise, and diet, is absolutely what GPs do,” he said.
However, he said this was conditional on ensuring GPs received the right information and support, and on working closely with oncology providers and geriatricians, particularly to address the substantial increase in older cancer survivors.
Across the sensitivity analyses, he said that the predicted number of people living with cancer in 2050 ranged from 2.3 to 2.9 million, based on current trends and available treatments.
The projections did not capture future changes in treatment effectiveness or new screening programs, such as the national lung cancer screening program introduced in July 2025.
The whole-of-population study also did not account for disparities across population subgroups, including Aboriginal and Torres Strait Islander people, rural populations, and socioeconomically disadvantaged groups.
“Further research is vital to estimate future disparities in cancer prevalence and develop dedicated benchmarks for different priority populations, thereby supporting long-term health care planning,” the researchers said.
The study was conducted in the Daffodil Centre and Cancer Council NSW, in scientific collaboration with researchers from the Cancer Elimination Collaboration at the University of Sydney and the Australian Cancer Survivorship Centre at Peter MacCallum Cancer Centre.
Read the full report here.
