Also, in reference to US you need to keep in mind that until very recently there was widespread use of hormones after menopause. After this turned out to have more problems than benefits, many women went off this treatment and the breast cancer rate, which had been extremely high, fell sharply. Breast cancer caused by menopausal hormone use is now known to have a relatively good prognosis.
I think that the most common reason why women with primary cancer at least refuse conventional treatment is if they distrust conventional medicine and put their faith in something else they think will work, not that they are actively suicidal. I think that that is what happened with Caron Keating.
I have heard of a few cases where women have committed suicide on diagnosis, often if they have had a relative die. This is unfortunate because there have been improvements in treatment. There is a heightened suicide risk among those diagnosed with breast cancer for at least twenty years after diagnosis, but not enough to make a huge difference in the stats. Most people cling to life for all it is worth.
Just caught this debate and cannot contribute in the way you'd like but has anyone ever seen any stats on suicides? Some women surely must commit suicide if only a few. Some must commit it passively by refusing treatment. Some must do it quietly by avoiding screening because of the possible outcome in terms of mutilation, go on to become quite ill and then perhaps be in such pain as they need palliative care/relief and are then (knowingly) diagnosed way too late for treatment and die fairly quickly.
Sorry, worded this a bit clumsily. Just wondering ...
Yes I've heard this too. 45 million people in the US don't have med insurance and I am sure those who get breast acncer and don't have insurance somehow get missed out of the stats. We hear a lot anecdotally here about more treatment options being available in USA but in reality only the most expensive and exclusive med insurance pays out for contested drugs like avastin.
Comparison with France is probably more legtitimate.
I'll look at the NYT report.
I overheard a conversation among the onc nurses the other day where they were questioning the veracity of US cancer figures. Something to do with the state by state accumulation of data and cherry picking from the healthiest (rich & white) communities while excluding the unhealthiest (poor & black/latino).
I am curious to find out more on this.
The NY Times has an interesting report today on a finding by Yale Medical School revealing the current US lung cancer stats to be "statistical artifact".
Thanks MsMolly and Suzannep...it was the CRUK figures I was looking for and thought I had checked.! From memory it looks as though the death rates are a couple of hundred down on 2005...so yes they are still going down but not what I'd call a brilliant reduction.
Diagnosis figures up again to nearly 46,000...though yes many of these may be because of better screening. Yes there is a real debate to be had about whether screening is really all its cut out to be. It improves the 5 years survival rates, but the unpalatable truth is that many aggressive cancers will kill no matter how 'early' they are picked up. Michael Baum has written interesting stuff on the problems with breast screening...google him for links.
Difficult to get much sense of comparative figures form the CRUK graphs...but does show enough that UK mortlaity rates behind France and USA but hard to judge how much.
Cancer Research's site show the trend for bc mortality in 2006 to be falling:
"Breast cancer mortality rates in the UK have fallen dramatically since 1989 when 15,625 women died from the disease compared with 12,319 in 2006. Over the same period the breast cancer age-standardised death rates have fallen by 34% from 42 to 28 per 100,000 women.
Between 1989 and 2006 the breast cancer mortality rate fell by 43% in women aged 40-49 years; by 39% in women aged 50-64; by 37% in women aged 65-69; by 32% in women aged 15-39; and by 16% in women.
The reduction in breast cancer mortality rates is likely to have several different causes including screening, increasing specialisation of care and the widespread adoption of tamoxifen treatment since 1992".
I read today on Dr Susan Love's site that although bc is being picked up earlier as a result of routine screening, mammography is not necessarily saving more lives as those picked up early are perhaps going to have a good prognosis and might be inflating the survival rates.
Cancer Research have some 2006 breast cancer figures. 12,392 bc deaths in 2006. We can't post links here can we - put "breast cancer deaths 2006" into Google.
During a chat with my consultant oncologist the other day he said that his department was seeing a marked increase in people presenting with early stage breast cancers. (Possibly because they have a very effective one-stop breast clinic). If that is the general trend nationwide then total survival stats will swing upwards simply because general prognosis is better - but that has always been the case and so we are not really advancing.
I am frustrated also by retrospective studies endeavouring to draw conclusions about patient groups from the 80s and 90s. What is the point? These studies are cheap to fund and quick to arrange and execute because it is just data juggling - but it contributes zilch to a progressive research agenda I think.
I think it's the office of national statistics that publish the data so the latest would be there. I'd be interested to see the most recent data but it always seems to be years out of date. Everything I've read in the past indicates Great Britain is lagging behind Europe (at least most countries) and behind the US for every cancer. Which is why cancer tsar Mike Richards is around, and NICE is producing guidance for doctors so that we have more consistent treatment for cancer. Giving PCTs the budgets hasn't helped as they are all spending different amounts and they know nothing about cancer by and large. So I don't see a very positive picture.
Sorry can't be of any assistance, but would love to know myself. As you say there is alot of speculation and very little hard data.
If you do find anything out I would be keen to know.
Does anyone know:
a) when the 2006 figures for breast cancer deaths and diagnoses will be publsihed (most recent I can find are still 2005)
b) the most recent world/European comparative survival rates for breast cancer?
Just curious...its hard to comment on debates about UK performance in these areas without the hard data. (rather than speculation of which there is a lot.)