Breast cancer survival and background – why the difference?

Inequalities matter in health. One of our goals as a charity is to help ensure that everyone in the UK – no matter what their background or where they live – has equal access to the best treatment for cancer. But the evidence shows that people from different backgrounds have different cancer outcomes. The big question is – why?

A new analysis of breast cancer survival rates, published today by the National Cancer Intelligence Network (NCIN), suggests that spotting cancer early may be one of the key reasons.

The ‘All Breast Cancer’ report (PDF) is a comprehensive analysis of women with breast cancer. Its authors collated in-depth data on a wide range of factors, including how long women survived, how they were diagnosed, and their socio-economic background.

To make things easy to compare, they divided the women into five groups, ranging from the least deprived (or affluent) to the most deprived.

The report’s key finding is illustrated here:

Click to enlarge

Among women diagnosed via the national breast cancer screening programmes across the UK, their background was almost irrelevant. There was very little difference in the percentage of women who survived their disease for at least five years (99 per cent among the most well-off group, against 94 per cent of the least well-off fifth).

But among women who were diagnosed in other ways – for example by finding a lump themselves and going to see a doctor – there was a stark difference. Just 68 per cent of the poorest women survived their breast cancer for at least five years, compared with 83 per cent of the most affluent.

(It’s worth noting that the ‘diagnosed by other routes’ group contained a wider age range than the ‘diagnosed by screening’ group, which may have had an effect on the results).

This difference means two things.

Firstly, it suggests that women from the most deprived backgrounds who don’t attend screening, but who go on to develop breast cancer, are probably being diagnosed at a later stage, when treatment is less likely to be as successful. This could be for a number of reasons, including lower awareness of symptoms or being more hesitant about seeing the doctor.

Secondly, it shows how important screening is in detecting cancers early. Making sure women from all backgrounds are aware of the potential benefits of breast screening is crucial. We need to redouble our efforts to make sure as many women as possible have access to appropriate information about screening.

Breast cancer is one of the success stories of recent years. Survival rates are improving, death rates are falling, and treatments have improved. We need to make sure that everyone benefits from the hard work of our doctors and researchers.

Henry

• Read the full report (PDF file)
• More about inequality and cancer