UK breast cancer mortality fall greater than expected
MedWire News: Breast cancer deaths have fallen more in the UK in the past two decades than in any other major European country, study findings indicate.
These results challenge claims that survival after breast cancer is worse in the UK than elsewhere in western Europe.
Philippe Autier (International Prevention Research Institute, Lyon, France) and collaborators used World Health Organization data to examine changes in breast cancer mortality rates among women living in 30 European countries from 1989 to 2006.
During the study period, breast cancer mortality decreased by 20% or more in 15 countries, and the reduction tended to be greater in countries with higher mortality rates at the start of the study.
The greatest decrease in mortality was observed in Iceland, at 45%, followed by England and Wales, Scotland, and Northern Ireland, at 35%, 30%, and 29%, respectively.
In France, Finland, and Sweden, countries that have also invested considerable resources in breast screening and new cancer drugs, mortality decreased by 11%, 12%, and 16%, respectively. In contrast, mortality did not decline or even increased in central European countries.
Women younger than 50 years had the biggest reductions in mortality rates, at 37%. The reductions for women aged 50 to 69 years and aged 70 years or older were 21% and 2%, respectively.
The authors note that downward mortality trends usually started between 1988 and 1996, and persisted from 1999 to 2006, indicating that breast cancer mortality is likely to continue to decrease beyond 2006.
Writing in the British Medical Journal, Autier et al call for better data collection to help understand the variations in breast cancer mortality across Europe and action to reduce avoidable breast cancer mortality in central European countries.
In an accompanying editorial, Valerie Beral and Richard Peto, from the University of Oxford in the UK, say that UK cancer survival statistics make survival look worse than it is because of shortcomings in the way cancers are registered. In contrast, population-based mortality rates, as used in the current study, are reasonably reliable.
They conclude that the rapid decline in UK population-based breast cancer mortality rates is valid and that failure to make proper allowances for the shortcomings of cancer registration data "may well have led to misleading claims about the supposed inferiority of UK cancer treatment services in general."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Laura Dean