Abstract
Background:Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain.Methods:We analysed data on East of England women with breast cancer (2006–2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70–74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights.Results:For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70–74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population).Conclusions:The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.
Highlights
Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain
Age gaps in cancer survival have been greatest in the UK and Ireland (De Angelis et al, 2014)
In England, older persons are at a greater risk of advanced stage at diagnosis of melanoma, endometrial and breast cancers (Lyratzopoulos et al, 2013a)
Summary
We analysed data on East of England women with breast cancer (2006–2010) aged 70 þ years. We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75 þ years had the hypothetical stage distribution. We analysed time from diagnosis to death for East of England women aged 70 years or over with a new diagnosis of breast cancer (International Classification of Diseases–10 site code C50) during 2006–2010, with follow-up on mortality until 15 March 2012. As described previously (Rutherford et al, 2013b), the data were extracted from the (former) Eastern Cancer Registration and Information Centre (ECRIC), a cancer registry covering a population of B5.7 million across the East of England region.
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