Survival rates for breast cancer in older women could be significantly improved by a simple awareness programme that promotes early presentation of the disease, according to results of the first trial of its kind presented at the National Cancer Research Institute Conference in Birmingham today (Sunday).
Researchers funded by Cancer Research UK aimed to determine the most effective means of improving breast cancer awareness. 460 women aged between 67 and 72 were recruited for the study as they attended their last mammogram on the NHS breast cancer screening programme, which routinely invites women aged 50 to 70 for screening.
The focus on increasing awareness in older women, including the option to attend screening after the upper age of the screening programme, is especially timely following Prime Minister Gordon Brown’s announced extension of the programme to invite women between the ages of 47 and 73 for screening.
This study – the first study looking at raising breast awareness in older women – will soon enter a new stage involving over 100,000 women across eight regions.
Women were offered an interactive educational booklet or a ten-minute interview with a radiographer plus the booklet when they attended their last routine screening mammogram. These interventions led to a significant increase in women’s levels of knowledge about all the possible symptoms of breast cancer, their awareness of their personal risk of developing breast cancer and their confidence to detect a change in their breasts which may be cancer.
Lead researcher and director of the Cancer Research UK London Psychosocial Group at King’s College London Professor Amanda Ramirez said: “Our study aimed to give older women the knowledge, awareness and skills to detect a breast change, as well as the confidence and commitment to go to the doctor straightaway with any such change. We have targeted our intervention at older women – a group at high risk of the disease – without making women at a lower risk unnecessarily anxious.
“The significant increase in women identifying the symptoms of breast cancer, awareness of their risk of developing the disease and their likelihood of checking their breasts for any changes is very encouraging. Simple techniques like providing accessible information booklets and a short interview with a radiographer could help save the lives of many women. We now need to examine whether the techniques will not only raise breast awareness but also decrease the chances that women who develop breast cancer will delay their presentation with the disease.”
Lower survival rates for a number of cancers in the UK compared with other countries have been attributed in part to delays in diagnosis and treatment – one reason for this being lack of public awareness around the symptoms of cancer. Reviews of research into the effects of delaying diagnosis and treatment for more than three months after the onset of symptoms show an association with worse survival rates than shorter delays.
Although the current NHS Breast Cancer Screening Programme routinely invites women aged 50 to 70 for screening, a third of breast cancers occur in women over 70 when survival rates are worse than in younger women.
Miss Gunna Dietrich, who took part in the trial, said: “Taking part in the research programme really helped me understand more about my risk of developing breast cancer. I enjoyed being included in the study and was surprised to hear that breast cancer is more common in older women. I now intend to go on inviting myself for breast screening. I’m more aware of breast cancer symptoms – that it’s not only a breast lump that can be cancer but other symptoms such as changes to the nipple. I felt more confident after the interview that I would notice a change in my own breasts.”
Sara Hiom, Cancer Research UK’s director of health information, said: “Age is the strongest factor linked to a woman’s risk of developing breast cancer. Many women don’t know this risk continues to increase past the age of 70 when they are no longer eligible for the NHS screening programme so it’s great to see research into ways to extend this awareness to older people.”
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Professor Ramirez’s promoting early presentation intervention programme includes a breast checking regime detailed in the information booklet. Women were encouraged to check their breasts for abnormalities and report them to a GP straightaway. Selected women were given a ten-minute interview with a radiographer in addition to the booklet, during which they were shown photographs of the breast changes associated with early breast cancer and encouraged to practise self-checking with a silicone breast model.
The NHS Breast Screening Programme
- The NHS Breast Screening programme provides free breast screening every three years for all women in England aged 50 and over. Women aged between 50 and 70 and registered with a GP are automatically invited every three years. There is no upper age limit for breast screening and so women over 70 can make their own appointments by contacting their local breast screening unit. The planned extension of this programme will stretch to invite women aged between 47 and 73 for routine screening.
- Women are encouraged to make an informed choice about whether or not to attend for screening. The programme aims to provide balanced information to assist them in making a decision. Along with the invitation, women receive a copy of a leaflet entitled Breast Screening – The Facts. Developed in collaboration with Cancer Research UK, Oxford University and women, the leaflet clearly explains the purpose of breast screening and the benefits and limitations of the test. It is available in 19 different languages.
- The report ‘Screening for Breast Cancer in England: Past and Future’, published in 2006, reviewed all available evidence on the benefits and risks associated with the NHS Breast Screening Programme to draw firm conclusions about its effectiveness. It is available on the screening programmes’ website www.cancerscreening.nhs.uk.
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About the NCRI Cancer Conference
The National Cancer Research Institute (NCRI) Cancer Conference is the UK’s premier forum for disseminating advances across all aspects of cancer research.
AstraZeneca is the gold sponsor for the NCRI Cancer Conference 2007.
About the NCRI
The National Cancer Research Institute (NCRI) was established in April 2001. It is a partnership between government, the voluntary sector and the private sector, with the primary mission of maximising patient benefit that accrues from cancer research in the UK through coordination of effort and joint planning towards an integrated national strategy for cancer research.
The NCRI consists of: The Association of British Pharmaceutical Industry (ABPI); The Association for International Cancer Research; The Biotechnology and Biological Sciences Research Council; Breakthrough Breast Cancer; Breast Cancer Campaign; Cancer Research UK; Department of Health; Economic and Social Research Council; Leukaemia Research Fund; Ludwig Institute for Cancer Research; Macmillan Cancer Support; Marie Curie Cancer Care; The Medical Research Council; Northern Ireland Health and Personal Social Services Research & Development Office; Roy Castle Lung Cancer Foundation; Scottish Executive Health Department; Tenovus; Wales Office of Research and Development for Health & Social Care; Wellcome Trust; and Yorkshire Cancer Research.