Death rate from breast cancer falls, more women living longer: Cancer Society

More women with breast cancer are surviving longer than in the past and a significantly smaller proportion are dying from the disease, says the Canadian Cancer Society, which released its latest statistics Wednesday.

A special report in Canadian Cancer Statistics 2007 shows the breast cancer death rate among Canadian women has dropped by 25 per cent in the last two decades and that 86 per cent of women diagnosed with the disease are surviving at least five years. The survival stat excludes Quebec, which collects data differently than other provinces.

"That really makes you stop, that's a startling drop in the death rates for breast cancer," said Heather Logan, director of cancer control policy for the society. "In addition, we're starting to see the (breast cancer) survival rate is one of the best of all of the cancers diagnosed."

There was also some heartening news about cancer incidence and deaths among men. Overall, cancer mortality rates have declined since 1998, primarily because of dwindling death rates for the most common malignancies among males - lung, prostate and colorectal.

"So that's good news," said Logan, citing drops in lung cancer cases in particular. "That means that their risk overall of developing cancer is beginning to decline."

But the same can't be said for women, whose diagnoses and deaths from lung cancer "remain persistently and stubbornly higher because tobacco (use) rates didn't decline until the middle of the 1980s. We're hoping that's going to start coming down soon, but we're not seeing that yet."

But when it comes to breast cancer, depending on age, the rates of new cases are either stable or declining slightly, the report shows. Among women aged 40 to 49, for instance, incidence declined 0.7 per cent per year over the last decade.

A number of factors are thought to be behind the improved statistics, from increased use of mammography screening to better treatments to healthier lifestyles among more women.

"We're diagnosing cancers at an earlier stage because women are being screened," said Logan. "And as you screen women regularly you'll be able to shift the stage of diagnosis, so the breast cancers are being diagnosed at an earlier stage when we can treat them more effectively."

In December, a study suggested U.S. breast cancer rates had plunged an unprecedented seven per cent in 2003, the year after millions of women stopped taking hormone replacement therapy (HRT) over fears the pills raise the risk of tumours. The analysis does not prove a link between hormone therapy and breast cancer, but strongly suggests it, many experts said.

It's too early to tell for sure from current Canadian data, but it appears that a drop in the HRT use may also have improved incidence rates in this country, said Logan. But she suggested the better breast cancer numbers have likely arisen from multiple factors.

"The messages that women have been hearing - 'Take charge of your life, be proactive, be informed, get screened' - they're starting to take hold and they're starting to make a difference."

That's a message that has become 57-year-old Jane Hawley's mantra - and she's not shy about repeating it.

The Toronto special education teacher discovered she had breast cancer in January 2003 after her doctor pushed her to get a mammogram, which she had wanted to put off several months to a more convenient time. Within two weeks, she had been diagnosed, had her small lump removed and begun treatment.

"I was extremely lucky," said the married mother of two grown children. "I'm four years clear now."

Hawley tells friends who are reluctant to get a mammogram: "Don't be stupid."

"Definitely go for your yearly physical and your mammogram for sure. For the little bit of inconvenience that it is, it's a lifesaver."

Despite the somewhat rosier picture for breast cancer, the disease continues to take a huge toll on the lives of Canadian women.

This year, an estimated 22,300 will be diagnosed with a breast malignancy, the most commonly diagnosed cancer in females and the second most common cause of cancer death, after lung cancer. By year's end, 5,300 women across the country are expected to die from breast cancer.

Yet Dr. Pam Goodwin, director of the Marvelle Koffler Breast Centre at Toronto's Mount Sinai Hospital, said the new Cancer Society statistics indicate "real progress" is being made against the disease.

"We're seeing the lowest mortality rates in breast cancer that we've seen since the mid-1950s," Goodwin said Tuesday. "The incidence rates are very, very interesting. Overall, I think we're at the cusp and we're now starting on the decline in incidence rates."

A few more years of data are needed to confirm that this is a trend, she said, "but I think this is a real observation. I think going forward we're going to see those rates overall slowly edge down."

Goodwin said the improved outlook for breast cancer is partly due to better treatments.

"There's been a lot of progress in the last 20 years and it's been step-wise. So we've gone from not giving women any treatment to giving chemotherapy, and more and more effective chemotherapy over time," she said, pointing to the long-used standard, tamoxifen, and newer drugs like Herceptin and the hormone-controlling drugs known as aromatase inhibitors.

"There hasn't been a single breakthrough, but all of these things add together to lower the likelihood that a woman diagnosed with breast cancer will die of breast cancer," she said.

"Breast cancer's not one disease. There's not going to be one advance that is going to eradicate the disease or make it completely curable."

"So it's going to be a series of baby steps that together are going to add up to the big impact."

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On the Net:

Canadian Cancer Society: www.cancer.ca

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Some other cancer statistics

(CP) - Here are some other facts from Canadian Cancer Statistics 2007:

-An estimated 159,900 Canadians will be diagnosed with cancer and 72,700 will die from the disease this year.

-Death rates have declined for all cancers combined and for most types of cancer in both men and women since 1994. Exceptions are lung cancer in women and liver cancer in men.

-Despite largely stable or declining age-standardized rates, the total number of new cancer cases and deaths continue to rise steadily as the Canadian population grows and ages.

-An estimated 39 per cent of Canadian females and 44 per cent of males will develop cancer during their lifetimes.

-Among those diagnosed between 1996 and 1998, the five-year relative survival for all cancers combined was 60 per cent.

-The overall death rate for men has been declining since 1988 due to decreases in mortality rates for lung, prostate, colorectal and other cancers.

-Between 1994 and 2003, the incidence of larynx, lung and stomach cancers among men dropped two per cent or more per year, as did death rates for testicular, Hodgkin's lymphoma, stomach, larynx, prostate, oral, non-Hodgkin's lymphoma and lung cancer.

-However, a higher proportion of men developed thyroid and liver cancers and malignant melanoma.

-For women, the overall death rate since 1988 has fallen slightly, while the rate of new cancer cases has been rising steadily (due largely to increasing lung cancer incidence), but may be stabilizing.

-Between 1994 and 2003, the incidence of larynx, stomach and cervical cancers fell by two per cent or more per year, and death rates for the latter two also dropped. However, the rate of new thyroid cancers rose.

Source : mediresource