Abstract
Background
The marked improvement in breast cancer mortality in the United Kingdom (UK) has attracted worldwide interest. To understand the details of this phenomenon the morbidity and mortality rates of breast cancer in the UK during the past 30 years were analyzed.
Methods
The official publications and statistical data were available and downloaded at the official UK Web sites of the National Health Service, National Statistics and Cancer Research Organization. Parts of the data were obtained directly from the National Cancer Intelligence Centre of UK.
Results
After the beginning of breast screening the morbidity of the subject age group soared up to the level of an age group that was 10 years older. Noninvasive carcinoma was often discovered in the subject age group after the beginning of breast screening and constituted 8.3% of all cases. The mortality rates, however, began to decrease before the start of screening and fell clearly even in age groups other than that of the study group and particularly in elderly women.
Conclusions
Not only the prevalence of breast screening but also the increase of early stage cancer in all age groups have probably resulted from improvements in diagnostic technology and heightened social interest and awareness. In addition, the development of adjuvant endocrine therapy must have influenced the evident improvement in mortality of breast cancer in the UK.
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Abbreviations
- IDC:
-
Invasive ductal carcinoma
- DCIS:
-
Ductal carcinomain situ
- ER:
-
Estrogen receptor
- IARC:
-
International Agency for Research on Cancer
References
Beral V, Hermon C, Reeves G, Peto R: Sudden fall in breast cancer death rates in England and Wales.Lancet 24:1642–1643,1995.
Peto R, Boreham J, Clarke M, Davies C, Veral V: UK and USA breast cancer deaths down 25% in year 2000 at ages 20-69 years.Lancet 355:1822, 2000.
Blanks RG, Moss SM, McGahan CE, Quinn MJ, Babb PJ: Effect of NHS breast screening programme on mortality from breast cancer in England and Wales, 1990-8: comparison of observed with predicted mortality.Br Med J 16:665–669,2000.
Nystrom L, Andersson I, Bjurstman N, Frisell J, Nor-denskjold B, Rutqvist LE: Long-term effects of mam-mography screening: updated overview of the Swedish randomized trials.Lancet 359:909–919, 2002.
Ueda K, Tsukuma H, Tanaka H, Ajiki W, Oshima A: Estimation of individualized probabilities of developing breast cancer for Japanese women.Breast Cancer 10:54–62, 2003.
Bray F, Sankila R, Ferlay J, Parkin DM: Estimates of cancer incidence and mortality in Europe in 1995.Eur J Cancer 38:99–166,2002.
Personal information from Mr. Nicola Cooper, a Senior Cancer Epidemiologist, National Cancer Intelligence Centre, Office for National Statistics, UK.
NHS Breast Screening Programme: Annual Review 1999 (from ref. 8).
(No authors sited): Controlled trial of tamoxifen as single adjuvant agent in management of early breast cancer. Analysis at six years by Nolvadex Adjuvant Trial Organization.Lancet 1:836–840,1985.
Ribeiro G, Swindell R: The Christie Hospital tamoxifen (Nolvadex) adjuvant trial for operable breast carcinoma—7 year results.Eur J Cancer Clin Oncol 21:897–900,1985.
(No authors sited): Adjuvant tamoxifen in the management of operable breast cancer: The Scottish Trial. Report from the Breast Cancer Trials Committee, Scottish Cancer Trials Office (MRC), Edinburgh.Lancet 2:171–175,1987.
Singh L, Wilson AJ, Baum M, Whimster WF, Birch IH, Jackson IM, Lowrey C, Palmer MK: The relationship between histological grade, oestrogen receptor status, events and survival at 8 years in the NATO (Nolvadex) trial.Br J Cancer 57:612–614,1988.
Ribeiro G, Swindell R The Christie hospital adjuvant tamoxifen trial—status at 10 years.Br J Cancer 57:601–603,1988.
Blanks RG, Moss SM, McGahan CE, Quinn MJ, Rabb PJ: Effect of NHS Breast Cancer Screening Programme on Mortality from Breast Cancer in England and Wales, 1990-8: Comparison of Observed with Predicted Mortality.Br Med J 16:665–669,2000.
International Agency for Research for Cancer (IARC): Handbooks on Cancer Prevention, volume 7: Breast Cancer Screening, IARC, Lyons, 2002.
NHS Breast Screening Programme: Annual Review 2001. Informing choice in breast screening (from ref. 8).
Nystrom L, Andersso I, Bjurstam N, Frisell J, Nor-denskjold B, Rutqvist LE: Long-term effects of mam-mography screening: Updated overview of the Swedish randomized trials.Lancet 359:909–919,2002.
Otto SJ, Fracheboud J, Looman CW, Broeders MJ, Boer R, Hendriks JH, Verbek AL, de Koning HJ, National Evaluation Team for Breast Screening: Initiation of population-based mammography screening in Dutch municipalities and effect on breast-cancer mortality: a systemic review.Lancet 361:1411–1417, 2003.
Internet Based References
httpy/www.cancerscreening.nhs.uk/index.html
http://www.cancerscreening.nhs.uk/breastscreen/ publications/
http://www.statistics.gov.uk/STATBASE/Product. asp?vlnk=8843
http://www.statistics.gov.uk/downloads/theme_ health/cancertrends_5099.pdf
http://www.cancerresearchuk.org/aboutcancer
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Kobayashi, S. What caused the decline in breast cancer mortality in the united kingdom?. Breast Cancer 11, 156–159 (2004). https://doi.org/10.1007/BF02968295
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DOI: https://doi.org/10.1007/BF02968295