title: Australia is continuing to make progress against cancer, but the regional and remote disadvantage remains.
abstract: OBJECTIVE
  To measure progress, over the past decade, in reducing the disadvantage in cancer death rates among people living in regional and remote areas of Australia.
  
  
  METHODS
  Analysis of routinely collected death certificate and corresponding population data from the Australian Bureau of Statistics.
  
  
  METHODS
  Population-based, Australia-wide comparison of mortality rates in regional and remote areas compared with metropolitan areas from 1 January 2001 to 31 December 2010.
  
  
  METHODS
  Absolute and relative excess of cancer deaths in regional and remote areas.
  
  
  RESULTS
  The number of excess cancer deaths in regional and remote areas from 2001 to 2010 was 8878 (95% CI, 8187-9572). For men, the age-standardised mortality ratios (comparing regional and remote areas with metropolitan areas) showed no evidence of improvement, from 1.08 in 1997-2000 to 1.11 in 2006-2010. For women, they increased from 1.01 in 1997-2000 to 1.07 in 2006-2010. The age-standardised cancer death rate in regional and remote areas (annual percentage change [APC], - 0.6%; 95% CI, - 0.8% to - 0.4%) is decreasing more slowly than in metropolitan areas (APC, - 1.1%; 95% CI, - 1.3% to - 1.0%).
  
  
  CONCLUSIONS
  The regional and remote disadvantage for cancer deaths has been recognised as a problem for more than two decades, yet we have made little progress. This is not surprising - we have not invested in research into solutions. The benefits of laboratory and clinical research to identify innovative cancer treatments will not be fully realised across the entire Australian population unless we also invest in health systems and policy research.
authors.affiliation: Health Services Research, Murdoch Childrens Research Institute, Melbourne, VIC, Australia. michael.coory@mcri.edu.au.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Coory
authors.forename: Tsun
authors.initials: T
authors.lastname: Ho
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Jordan
mesh_terms: D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000401:mortality; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D009369:Neoplasms / Q000401:mortality*; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D014505:Urban Population / Q000706:statistics & numerical data