A presentation to be held at the 9th European Breast Cancer Conference today will reveal the latest figures that provide insight into the global burden of breast cancer. And although there are some signs of positivity in reducing this burden, it is clear there is still a lot more work to be done.
According to Prof. Peter Boyle, director of the University of Strathclyde Institute of Global Public Health at the International Prevention Research Institute (iPRI) in France, over 1.6 million cases of breast cancer are still being diagnosed each year.
Breast cancer incidence has been increasing at a rate of 3.1% every year, and there are around 450,000 deaths from the disease annually.
But Prof. Boyle says that although the majority of new diagnoses are among women in developed countries, the number of deaths each year are now equally divided between developed and undeveloped countries.
He says this could be down to the different stages of breast cancer at which women are diagnosed in high- and low-income countries.
The iPRI published “The World Breast Cancer Report 2012,” which revealed that in high-income countries, such as the UK and Australia, not many women were initially diagnosed with stage III (advanced) and stage IV (metastatic) breast cancer.
But in low-income countries, such as Kenya and Uganda, almost all women diagnosed with the disease were already at these stages.
Prof. Boyle says these findings demonstrate that more needs to be done to ensure women in undeveloped countries receive earlier breast cancer diagnosis:
“Given that the difference in survival when going from a stage I to a stage II breast cancer is approximately 12 percentage points, and from a stage III to a stage IV around 30 percentage points, it is clear that our first priority should be to do all we can to encourage women in low-income countries to present to their doctor before their breast cancer is at such an advanced stage that cure is no longer possible.”
When it comes to increasing rates of breast cancer diagnosis, Prof. Boyle says that many factors contribute to this, such as increasing population size, longer life expectancy, increase in awareness of the disease and the introduction of early detection programs in countries with fewer resources.
But he says that to cope with the increase in breast cancer diagnosis, there need to be appropriate treatment facilities available – and he found this is not always the case, particularly in low-income countries.
He explains that in many undeveloped countries, there are often no radiotherapy facilities available, and when they are available, there are often not enough of them to make a significant difference.
Furthermore, Prof. Boyle says that many women in low-income countries with late-stage terminal breast cancer are often not able to get access to opioid medication to control their pain.
But it is not all bad news. Prof. Boyle says that in Scotland, the death rate from breast cancer is at its lowest in 100 years.
He says this is likely to be a result of the development and availability of effective treatments, the National Health Service (NHS) breast screening program, free access to high-quality treatment and diagnostic facilities, and overall increased awareness among women.
However, he points out that even in Scotland, there are significant differences between diagnosis and treatment of women as a result of lifestyle and social class.
Prof. Boyle cites a study detailing the outcomes of two women with breast cancer from Glasgow, Scotland. Both women were of the same age, had the same treatment at the same time and the same tumor characteristics.
But because one woman lived in a deprived area and the other lived in an affluent area, there was 10-point percentage difference in their 5-year survival rates.
Last year, Medical News Today reported on a study revealing that young women of a poor financial status may experience delays in breast cancer diagnosis and medical advice, compared with women of a higher financial status.
He says that it is a “matter of urgency” that such differences are eradicated.
Prof. Boyle concludes:
“While there is plenty of good news to report, at least in the developed world, what is particularly alarming is that there are still so many preventable deaths due to the combination of a lack of awareness and a lack of resources.
Epidemiology has a vital role to play both in elucidating the current situation and in bringing it to the notice of those who are able to do something about it.”