Older women in the UK are less likely to have surgery for breast cancer than younger ones. And this difference can’t be fully explained by age-related ill health from other diseases, according to new data presented today at the National Cancer Intelligence Network (NCIN) conference (Thursday).
Researchers1 looked at the records of more than 23,000 women with breast cancer2 diagnosed in the West Midlands, Yorkshire and North East of England between 1997 and 2005 to investigate whether women aged over 70 in the UK are less likely to have surgery because of other illnesses3.
They found that, overall, surgery rates dropped off with age and women who had other illnesses were less likely to have surgery. But even after taking other illnesses into account the chances of having surgery still fell with age – over 85 per cent of women aged 65 to 70 had surgery, but this fell to 70 per cent in those over 70. And to only 50 per cent of the over 80s.
Older patients were also less likely to have surgery if they were from a deprived area4.
Dr Katrina Lavelle, lead study author from the University of Manchester, said: “Previous research has shown that older women are less likely to have surgery for breast cancer compared with younger patients. Surgery to remove breast tumours is one of the most effective ways to treat this cancer so it’s important to get a better understanding of what lies behind these differences.
“This research suggests that the presence of other illnesses, which we know increases with age, does not fully explain the difference in treatment between older and younger patients.
“The good news is that over the time period we looked at, the numbers of women over 65 having surgery did rise from 68 per cent to 75 per cent.
“Our ongoing research, funded by the Breast Cancer Campaign and the National Institute for Health Research, is investigating the extent to which the lack of surgery amongst older women is due to things like overall frailty or patient choice. We are also developing statistical techniques to help to decide which treatment is likely to be the most appropriate based on patient choice, health and acceptable risk, rather than age.”
Steven Oliver, study author from the Northern and Yorkshire Cancer Registry and Information Service (NYCRIS), said: “This study illustrates the important role the UK’s cancer registry system plays in improving cancer care. By recording the patterns of treatment received by all patients with cancer we have a vital resource that can form the basis for research to understand why care varies.”
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- Oliver S et al, Is the lack of surgery amongst older postmenopausal women with breast cancer in the UK explained by co-morbidity? NCIN Conference 2011 abstracts, p44.
- The team included researchers from the University of Manchester, University of Leeds, University of York and the Hull York Medical School and from the Northern and Yorkshire Cancer Registry and Information Service (NYCRIS) and the West Midlands Cancer Intelligence Unit (WMCIU). Researchers received funding from the National Institute for Health Research and Cancer Research UK.
- More than 48,000 women are diagnosed with breast cancer in the UK each year.
- Women over 70 are not routinely invited for screening but can request a mammogram.
- The Second All Breast Cancer Report was published by the NCIN last week which also looked at inequalities and variation in breast cancer outcomes with age and deprivation. The full report is available on the NCIN website www.ncin.org.uk