Older women with breast cancer face a higher risk of being diagnosed with the disease at a late stage, while the risk of an advanced stage diagnosis of lung cancer decreases with age, a new study shows today.
Researchers from the University of Cambridge and the Eastern Cancer Registration and Information Centre (ECRIC) said the study showed that efforts to diagnose cancer early need to be better tailored to different age groups.
The study, published in the British Journal of Cancer*, used ECRIC data on stage – a measure of how advanced the cancer is when diagnosed.
The research aimed to find whether there was a link between age or socio-economic background and being diagnosed with advanced stage cancer.
Researchers looked at around 17,800 women with breast cancer and over 13,200 patients with lung cancer in the east of England who were diagnosed between 2006 and 2009.
They found that compared to women aged 65-69, women aged 70-74 had a 21 per cent increased chance of a late stage breast cancer diagnosis.
The chance of an advanced breast cancer diagnosis became higher as women got older – even accounting for the effect of screening. For example, it was 46 per cent higher in women aged 75-79.**
In contrast, it was less likely that older patients would be diagnosed with advanced stage lung cancer than younger patients.
Compared with people aged 65-69, people aged 70-74 were 18 per cent less likely of be diagnosed with late stage lung cancer and this chance decreased further with age – for people aged 75-79 it was 26 per cent lower.
For breast cancer, the study also found that late stage diagnosis was more common in women from deprived backgrounds. For lung cancer, late stage diagnosis was more common in men.
Dr Georgios Lyratzopoulos, study author based at the University of Cambridge, said: “Patient awareness of the signs of breast cancer is known to be lower among older women and this may explain why breast cancer is diagnosed later among this age group.
“But it is puzzling why older patients have a lower risk of advanced stage lung cancer. More research is needed to better understand this pattern.”
The researchers added that the strong likelihood of older women being diagnosed with late stage breast cancer was worrying given that the risk of the disease increases with age.***
Dr David Greenberg, study author based at ECRIC, said: “Collecting staging data has proved difficult in the past but this data is vital to understanding how to improve the diagnosis of cancer. ECRIC has the most complete information on stage. A modernisation programme for cancer registries aims to improve the collection of such information nationwide by end of 2012.”
Sara Hiom, director of information at Cancer Research UK, said: “If cancer is caught early, patients usually have a better chance of beating the disease as more effective treatment options are available.
“We have made great progress in improving cancer survival rates in the last 40 years, but there is still more work to be done to help more people survive cancer.
“Collecting information on stage at diagnosis is vital to do this and we must think how to target messages appropriately to the right audiences.
“Cancer Research UK works to raise symptom awareness, and encourage and enable people to go visit their doctor as soon as their notice anything unusual for their bodies.”
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*Lyratzopoulos, G et al., Variation in advanced stage at diagnosis of lung and female breast cancer in an English region 2006-2009 British Journal of Cancer (2012)
**The data showed diagnosis of the cancer in stage three/four compared to diagnosis in stage one or two.
For breast cancer, the frequency of advanced stage at diagnosed increased with age. Compared to women aged 65-69, women aged 70-74 had a 21 per cent higher chance of late diagnosis. This increased to 46 per cent higher for those aged 75-79, 68 per cent higher for those aged 80 -84 and 78 per cent higher for those 85 and over.
For lung cancer, compared to 65-69 year olds, the chance of late stage diagnosis was 18 per cent lower for 70-74 year-olds, 26 per cent lower for those aged 75-79, 27 per cent lower for 80-84 year-olds and 34 per cent lower for those aged 85 and over.
Women aged between 50 and 74 were offered breast cancer screening during 2006 to 2009. Breast cancer screening is known to detect cancers at an earlier stage than those detected from symptoms. The researchers did adjust their analysis for whether a breast cancer was diagnosed by screening or not to account for different uptake of breast screening among difference age and deprivation groups
***Stage at diagnosis can have a big impact on women aged 70 and over with breast cancer. A third of all breast cancer cases occur in this age group. In this study 21 per cent of cases of all ages were diagnosed at stage 3 and 4 or the stage was unknown.
According to the Office for National Statistics, the life expectancy of a woman aged 70 is 16.5 years, while that of a woman aged 80 is 9.5 years. Preventing late stage diagnosis could help reduce avoidable mortality in this age group.
Stage at diagnosis can have a big impact on patients under-65 with lung cancer. A quarter of all lung cancer cases occur in this age group. In this study, only 17 per cent of lung cancer cases of all ages were diagnosed at stage one or two.