The cancer death rate is projected to drop from 148.7 per 100,000 this year to 144.2 per 100,000 in 2021, the report, released on Tuesday, said. Survival rates were on the rise for all nine major cancer types included in the report. "Prevention campaigns, cancer screening participation, access to services and new emerging therapies have all helped contribute to an overall reduction in mortality rates," said David Currow, chief cancer officer and chief executive of the Cancer Institute NSW. "Tackling fatalism is crucial," Professor Currow said. "The really important message is that if you are diagnosed in 2019 with cancer in NSW, you will get some of the best outcomes in the world and, if you're worried about it, please see your doctor."

Loading Following a federal election that underscored the inequity of cancer treatment in Australia, the report confirmed significant disparities in cancer incidence and survival depending on the type of cancer and where patients live. Between 2010 and 2014, more than nine in 10 breast cancer patients (90.6 per cent) were alive five years after they were first diagnosed in NSW; the highest of any state and territory. NSW also had the highest five-year survival rate for melanoma skin cancers at 93.9 per cent. For bowel cancer, it was more than 70 per cent. Yet roughly four in five people with lung or liver cancer died within five years. For stomach cancer, it was two in three.

Pancreatic cancer had the highest death rate, with 12 per cent of patients living five years after being diagnosed with the notoriously aggressive and hard-to-detect disease. But this figure was a hard-fought improvement. "I remember attending a national think tank in 2012 where the thought of getting into double-digit survival [for pancreatic cancer] seemed a faint hope," Professor Currow said. "We need to keep this in perspective, these are people's lives we are talking about ... but we are seeing a real and sustained shift," he said. Loading Replay Replay video Play video Play video But there was much more work to be done to redress the "unwarranted variations" in diagnosis and survival rates between local health districts, Professor Currow said.

Loading Lung cancer death rates - intrinsically linked to disadvantage and smoking - were significantly higher than the state average in the local health districts of South Western Sydney and Western NSW and low in the more affluent districts of Northern and South Eastern Sydney. Western NSW had the highest smoking rate in the state, more than 2.5 times the rate of Northern Sydney with the lowest rate of 9.5 per cent. Northern and South Eastern Sydney had some of the highest rates of breast cancer, for which - at a population level - social advantage is a known risk factor. The Central Coast, Mid North Coast and the Hunter New England districts had some of the highest skin cancer death rates, while Sydney, Northern, South Western and Western Sydney districts have some of the lowest in the state.

Meanwhile, bowel cancer rates were high in the Hunter New England, Central Coast and Mid North Coast and Murrumbidgee districts where the retirement population was booming. The report also showed an uptick in people taking part in national screening programs. Breast cancer screening participation ranged from 44.8 per cent in Far West NSW to 61.8 per cent in Hunter New England in 2016-2017. Statewide, 55.9 per cent of women aged 20 to 69 had been screened for cervical cancer between July 2015 and June 2017, almost 63,000 more than were screened from 2010 to 2012. NSW had the second-lowest participation rate for the National Bowel Cancer Screening Program in Australia (after the Northern Territory) of 38.2 per cent, but it had risen from 31.8 per cent in 2012.