What caused the decline in breast cancer mortality in the United Kingdom?
BACKGROUND
The marked improvement in breast cancer mortality in the United Kingdom (UK) has attracted worldwide interest. To understand the details of this phenomenon the morbidity and mortality rates of breast cancer in the UK during the past 30 years were analyzed.


METHODS
The official publications and statistical data were available and downloaded at the official UK Web sites of the National Health Service, National Statistics and Cancer Research Organization. Parts of the data were obtained directly from the National Cancer Intelligence Centre of UK.


RESULTS
After the beginning of breast screening the morbidity of the subject age group soared up to the level of an age group that was 10 years older. Noninvasive carcinoma was often discovered in the subject age group after the beginning of breast screening and constituted 8.3%of all cases. The mortality rates, however, began to decrease before the start of screening and fell clearly even in age groups other than that of the study group and particularly in elderly women.


CONCLUSIONS
Not only the prevalence of breast screening but also the increase of early stage cancer in all age groups have probably resulted from improvements in diagnostic technology and heightened social interest and awareness. In addition, the development of adjuvant endocrine therapy must have influenced the evident improvement in mortality of breast cancer in the UK.
Kobayashi
Shunzo
S
Nagoya City University Medical School, Nagoya, Japan. shunkoba-ngi@umin.ac.jp
D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality / Q000639:trends; D009313:National Health Programs; D009367:Neoplasm Staging; D010353:Patient Education as Topic; D012189:Retrospective Studies; D012924:Social Conditions; D006113:United Kingdom / Q000453:epidemiology