The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women.


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Authors
Rutherford, MJ 
Abel, GA 
Greenberg, DC 
Lambert, PC 
Lyratzopoulos, Georgios  ORCID logo  https://orcid.org/0000-0002-2873-7421
Abstract

BACKGROUND: Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain. METHODS: We analysed data on East of England women with breast cancer (2006-2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70-74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights. RESULTS: For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70-74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population). CONCLUSIONS: The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.

Description
Keywords
Age Factors, Aged, Aged, 80 and over, Breast Neoplasms, Carcinoma, Ductal, Breast, Carcinoma, Lobular, Cohort Studies, England, Female, Health Status Disparities, Healthcare Disparities, Humans, Socioeconomic Factors, Survival Rate
Journal Title
Br J Cancer
Conference Name
Journal ISSN
0007-0920
1532-1827
Volume Title
112
Publisher
Springer Science and Business Media LLC
Sponsorship
TCC (None)
This article is an independent research supported by different funding bodies, beyond the authors’ own employing organisations. MJR was partially funded by a Cancer Research UK Postdoctoral Fellowship (CRUK_A13275). GL is supported by a Postdoctoral Fellowship award by the National Institute for Health Research (NIHR PDF-2011-04-047) to end of 2014 and a Cancer Research UK Clinician Scientist Fellowship award (A18180) from 2015. We thank all staff at the National Cancer Registration Service, Public Health England, Eastern Office who helped collect and code data used in this study. We particularly acknowledge the help of Dr Clement H Brown and Dr Brian A Rous who were responsible for staging.