Cancer Leading Cause of Disease Burden in 2023, Study Finds

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Cancer is Australia’s leading cause of disease burden in 2023, followed by mental health and substance abuse.

The Australian Burden of Disease Study (ABDS) 2023 unveiled estimates of disease burden from 220 diseases and injuries in Australia in 2023.

The study (pdf), released by the Australian Institute of Health and Welfare (AIHW), considered the years of healthy life lost due to ill health along with years lost due to dying prematurely.

Burden of disease refers to the loss of a healthy life from injury, illness, or premature death.

The five disease groups causing the greatest burden in 2023 were cancer, mental health and substance use, musculoskeletal conditions, cardiovascular disease, and neurological conditions

“Cancer as a disease group contributed the most burden across all years of the study,” the authors noted.

COVID-19 was listed as 13th in the disease-causing burden in 2023, making up just 0.9 percent of the total burden on Australians and 1.5 percent of the fatal burden. However, according to the analysis, the burden from COVID-19 was mostly fatal at 83 percent.

The authors said coronary heart disease was the leading “specific” cause of burden in 2023, making up 5 percent of the total burden. This was followed by dementia at 4.4 percent, back pain and problems at 4.3 percent, and anxiety disorders at 3.9 percent.

“When considering individual diseases, coronary heart disease was the leading cause of burden for every reference year in the study,” the authors noted.

“However, the burden from coronary heart disease showed the largest absolute reduction over time and was mainly driven by large declines in fatal burden.”

The study also showed Australians are living longer on average and spending extra years in the best of health with no disease or injury.

For example, males born in 2023 are predicted to live 88 percent of their total life in full health, while females live 87 percent of their lives in full.

Despite this, the number of years lived in ill health is also rising, the study showed.

Cancer accounted for 17 percent of total burden, mental health and substance use made up 15 percent, musculoskeletal 13 percent, cardiovascular 12 percent, and neurological 8 percent.

The disease burden from mental health and substance use has risen between 2003 and 2023, while for cancer, it has fallen.

5.6 Million Years of Healthy Life Lost

Australians missed out on 5.6 million years of healthy life living with illness (non-fatal burden) and dying prematurely fatal burden) in 2023, the study found.

Living with illness accounted for 54 percent of this total burden, while the remaining 46 percent was due to dying prematurely.

“Living with illness or injury caused more disease burden than dying prematurely. Between 2003 and 2023, there has been a moderate shift from fatal burden to non-fatal burden being the biggest contributor to total burden,” the authors of the study said.

Males accounted for more total burden than females, due to having a higher rate of fatal burden.

“In 2023, the leading causes of total burden among males were coronary heart disease, back pain and problems, and suicide and self-inflicted injuries. Among females, the leading cause was dementia, followed by anxiety disorders and back pain and problems,” the study noted.

“Males experienced three times the amount of burden due to suicide and self-inflicted injuries and two times the amount of burden from coronary heart disease than females. Females experienced more burden than males from dementia and anxiety disorders.”

In the last 20 years, there was a 13 percent fall in the rate of fatal burden, while the non-fatal burden fell 15 percent during that time frame.

After calibrating for population ageing, there was an 11 percent fall in the total burden between 2003 and 2023. This took into account a 27 percent drop in the fatal burden and a non-fatal burden rate lift of 6.3 percent.

“Impacts due to the COVID‑19 pandemic may have caused or affected the burden due to other causes, including impacts due to restrictions and lockdowns,” the authors noted.

People queue in their cars to get tested for COVID-19 at a pop-up testing clinic at Bondi Beach in Sydney, Australia on June 25, 2021. Dean Lewins/AAP Image via AP

“Therefore, simply subtracting the disease burden due to COVID‑19 from the total burden does not necessarily reflect the true disease burden experienced had the COVID‑19 pandemic not occurred.”

2030 Predictions

The study estimates Australians will have at least two extra years of life at full health capacity by the year 2030.

In 2023, the study estimates males live 71.6 years in full health, while females live 73.6 years of life in the best of health.

This compares to 71.5 years in full health in 2018 for men and 74 years in full health for women.

In the first 25 years of life, 91.6 percent of Australians live in full health in 2023, compared to 92.1 percent in 2018.

“Australians are, on average, living longer and spending more years in full health (meaning no disease or injury). Years lived in full health is also referred to as the health-adjusted life expectancy,” the study noted.

“However, years lived in ill health are also increasing, resulting in little change in the proportion of life spent in full health.”