Date Published: 9 June 2011

Poorer women less likely to survive breast cancer

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The UK National Cancer Intelligence Network (NCIN) has recently released information about cancer survival rates and patients' economic circumstances.

The 'All Breast Cancer Report' is said to be the first in-depth analysis in the UK to look at how the impact of treatment and route of diagnosis ? either through screening or symptoms presented to a GP ? affects the chance of surviving the disease, among patients with different levels of poverty. It indicates that poorer women from deprived areas are less likely to survive breast cancer because they are generally diagnosed at a later stage and so the best available treatments are less effective for them than is generally the case when diagnoses are made at an earlier stage in development of breast cancer. This could, in part, explain why England's breast cancer survival rates are lower than in some other countries. That is: Poorer women are being diagnosed with more advanced stage tumours which are detected too late for surgery or need more aggressive treatment.

For women presenting with symptoms of breast cancer, the report found a 15% difference between the most (68%) and least (83%) deprived in those women who survive for more than five years. Theere was, however very little difference in survival between the most and least deprived women who were diagnosed through screening.

Gill Lawrence, director of the West Midlands Cancer Intelligence Unit and report author, said:

" These figures show that even though a greater number of affluent women develop breast cancer every year, poorer women are more likely to die from the disease. Not going for screening and delays in going to the doctor mean that less affluent women are being diagnosed with later stage cancers which need more invasive surgery and are far less likely to be treated with breast conserving surgery.
_ But, if these women attend screening, are breast aware and go to their doctor as soon as they notice anything unusual for them such as a lump or changes to the nipple like a rash or dimpling there's no reason why poorer women shouldn't have the same chance of survival as more affluent women."

Martin Lee, chair of the National Cancer Intelligence Network breast clinical reference group and consultant surgeon at University Hospitals Coventry and Warwickshire NHS Trust, said:

" Having a more advanced breast cancer at diagnosis is a double blow, as more aggressive treatments are needed, and the outlook is worse.
_I know from my own experience with patients that they find it more distressing to cope with the diagnosis if they need both mastectomy and chemotherapy. Fortunately breast screening with mammograms is finding earlier stage cancers that can be controlled by less radical treatments and have better survival; it is particularly encouraging to see that this is narrowing the gap in outcomes between affluent and deprived women."

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