Older Australians are defined by the Australian Institute of Health and Welfare (AIHW) as people aged 65 years and over, or 50 years and over for Indigenous Australians, reflecting the life expectancy gap between Indigenous and non-Indigenous Australians and the lower proportion of Indigenous people aged 65 and over.[72]
Australia’s population is ageing due to increasing life expectancy and declining fertility rates. As of 30 June 2020, approximately 4.2 million people or one in six Australians were aged 65 and over—this is 16% of Australia’s total population.[72] The number and percentage of older Australians is expected to continue to grow.
By 2066, it is projected that older people in Australia will make up between 21% and 23% of the total population.[72]
People identifying as belonging to diverse populations may identify across multiple priority population groups. This intersectionality can result in compounding impacts of social, cultural, commercial and environmental determinants of health on cancer experiences and outcomes.
Cancer is more common in older Australians. In 2023, it is estimated that 102,679 people aged 65 years and over will be diagnosed with cancer and that 41,295 people in this age group will die from cancer. The ageing population is expected to continue to contribute to an increasing number of cancer cases.[1][3]
Age discrimination combined with complex health needs are significant barriers to older people receiving cancer care and prevention and cancer screening services. Older Australians often face challenges in accessing and engaging with the essential support and services that will assist them to enjoy healthier lives.[73][74][75] This is particularly significant for older Australians who are culturally or linguistically diverse, LGBTIQA+, live alone, are homeless, or who need assistance with daily living.
Many older Australians report they are not consulted or included in the planning of their care, and health services important to the wellbeing of older Australians have long waiting lists and are difficult to access.[76]
The Australian Cancer Plan aims to improve health equity for older Australians.
This includes supporting consumer decision making by ensuring person-centred care is visible across the cancer continuum, developing education and training material regarding inclusive practices for healthcare providers, and developing innovative models of care, including consumer navigation models.
Year: 2017
Author: Department of Health and Aged Care, Australian Government
The Aged Care Diversity Framework aims to make sure our aged care system is accessible to all older Australians. It recognises that to support our diverse population, aged care needs to be respectful and inclusive of all people.
Year: 2022
Author: Victorian Department of Families, Fairness and Housing
The Ageing Well Action Plan 2022–2026 outlines the Victorian Government’s commitment to support Victorians to age well by continuing to participate in their community and safely ageing in-place at home, in the community, or aged care. One of the four areas for action is health.
Year: 2021
Author: Department of Communities and Justice NSW
The Ageing Well in NSW: Seniors Strategy 2021–2031 sets out the NSW Government’s 10-year plan to respond to the opportunities and challenges of an ageing population, along with an action plan to ensure people have healthy, active, and better lives in ageing.
Year: 2021
Authors: Department of Territory Families, Housing and Communities
The Northern Territory Seniors Policy 2021–2026 sets four priority areas, including health and wellbeing over a 5-year period. A range of actions have been outlined to provide future directions to address the demands of an ageing population.
Year: 2020
Author: SA Health
South Australia’s Plan for Ageing Well 2020–2025 outlines the priorities of the South Australian Government and community over the next five years to meet the vision for all South Australians.
Year: 2019
Author: Queensland Health
Queensland’s Healthy Ageing: A Strategy for Older Queenslanders aims to improve health services to ensure older Queenslanders remain in good health for longer.
Year: 2017
Author: Department of Premier and Cabinet
Tasmania’s Active Ageing Plan 2017–2022 supports individuals to make informed choices about their health and wellbeing, education, participation, and security. Health is one of the four areas for action.
Year: 2014
Author: Agency for Clinical Innovation
Building Partnerships: A Framework for Integrating Care for Older People with Complex Health Needs aims to support local health districts and local partnerships of agencies to redesign and implement improved models of care for older people in NSW.
Year: 2017
Author: Department of Health and Aged Care, Australian Government
The Aged Care Diversity Framework aims to make sure our aged care system is accessible to all older Australians. It recognises that to support our diverse population, aged care needs to be respectful and inclusive of all people.
Year: 2022
Author: Victorian Department of Families, Fairness and Housing
The Ageing Well Action Plan 2022–2026 outlines the Victorian Government’s commitment to support Victorians to age well by continuing to participate in their community and safely ageing in-place at home, in the community, or aged care. One of the four areas for action is health.
Year: 2021
Author: Department of Communities and Justice NSW
The Ageing Well in NSW: Seniors Strategy 2021–2031 sets out the NSW Government’s 10-year plan to respond to the opportunities and challenges of an ageing population, along with an action plan to ensure people have healthy, active, and better lives in ageing.
Year: 2021
Authors: Department of Territory Families, Housing and Communities
The Northern Territory Seniors Policy 2021–2026 sets four priority areas, including health and wellbeing over a 5-year period. A range of actions have been outlined to provide future directions to address the demands of an ageing population.
Year: 2020
Author: SA Health
South Australia’s Plan for Ageing Well 2020–2025 outlines the priorities of the South Australian Government and community over the next five years to meet the vision for all South Australians.
Year: 2019
Author: Queensland Health
Queensland’s Healthy Ageing: A Strategy for Older Queenslanders aims to improve health services to ensure older Queenslanders remain in good health for longer.
Year: 2017
Author: Department of Premier and Cabinet
Tasmania’s Active Ageing Plan 2017–2022 supports individuals to make informed choices about their health and wellbeing, education, participation, and security. Health is one of the four areas for action.
Year: 2014
Author: Agency for Clinical Innovation
Building Partnerships: A Framework for Integrating Care for Older People with Complex Health Needs aims to support local health districts and local partnerships of agencies to redesign and implement improved models of care for older people in NSW.
Personal experiences of ageism and discrimination in the health sector can be a significant barrier to older people accessing cancer screening and prevention programs.
Personal experiences of ageism and discrimination in the health sector can be a significant barrier to older people accessing cancer screening and prevention programs.
Stakeholders emphasised that older people frequently experience ageism and stigma that impact on their treatment options, with limited access to supportive, palliative, and end-of-life care. Stakeholders underlined the importance of including the older person in their own care, as well as carer involvement in health decisions. Training for health professionals and carers to better recognise and support the needs of older people was viewed as important, along with more tailored information, communication, and support for older Australians with cancer.
Ageism can be a significant barrier for older people in accessing quality cancer care as they often feel spoken down to or not consulted during their care journey.[73] Aged care services, including geriatric medicine, allied health, and community social support services, tend to better serve people with a slower trajectory of decline, therefore many older people may not be prioritised for their care, and waiting lists for specialist outpatient services can be longer.
There exist gaps in knowledge about how cancer progresses in older Australians with comorbid conditions. It was emphasised that sustained research is needed to improve understanding of how to treat older people with cancer, together with greater investment in clinical trials that directly improves their cancer care.
Stakeholders reported that age discrimination can be a barrier to receiving cancer care and to participating in research and clinical trials. Training to eliminate such age discrimination should be undertaken by all healthcare providers.
Nurses are playing an increasingly critical role in the age-related needs of older people with cancer. Increasing skills and competencies of the cancer and aged care workforce is needed to help meet the needs of the increasing number of older Australians with cancer.
Geriatricians should be included in the multidisciplinary care of older people with cancer given the complexities that need to be managed. Professional development opportunities in geriatric oncology should be promoted.
The Australian Cancer Plan considers an intersectional and health equity approach for Aboriginal and Torres Strait Islander people. This is more than recognising the multiple backgrounds, experiences, and ways Aboriginal and Torres Strait Islander people identify. This approach addresses the way membership of multiple groups may impact people's health and wellbeing needs and ability to access care.
Implementation of each action should consider the compounding impacts of intersectionality across other priority population groups.