title: Quantifying differences in breast cancer survival between England and Norway.
abstract: BACKGROUND
  Survival from breast cancer is lower in the UK than in some other European countries. We compared survival in England and Norway by age and time from diagnosis.
  
  
  METHODS
  We included 303,648 English and 24,919 Norwegian cases of breast cancer diagnosed 1996-2004 using flexible parametric relative survival models, enabling improved quantification of differences in survival. Crude probabilities were estimated to partition the probability of death due to all causes into that due to cancer and other causes and to estimate the number of "avoidable" deaths.
  
  
  RESULTS
  England had lower relative survival for all ages with the difference increasing with age. Much of the difference was due to higher excess mortality in England in the first few months after diagnosis. Older patients had a higher proportion of deaths due to other causes. At 5 years post diagnosis, a woman aged 85 in England had probabilities of 0.35 of dying of cancer and 0.32 of dying of other causes, whilst in Norway they were 0.26 and 0.35. By eight years the number of "avoidable" all-cause deaths in England was 1020 with the number of "avoidable" breast cancer related deaths 1488.
  
  
  CONCLUSIONS
  Lower breast cancer survival in England is mainly due to higher mortality in the first year after diagnosis. Crude probabilities aid our understanding of the impact of disease on individual patients and help assess different treatment options.
authors: Centre for Biostatistics and Genetic Epidemiology, Department of Health Sciences, 2nd Floor Adrian Building, University of Leicester, University Road, Leicester LE1 7RH, UK. paul.lambert@le.ac.uk
authors: Paul C
authors: PC
authors: Lambert
authors: Lars
authors: L
authors: Holmberg
authors: Fredrik
authors: F
authors: Sandin
authors: Freddie
authors: F
authors: Bray
authors: Karen M
authors: KM
authors: Linklater
authors: Arnie
authors: A
authors: Purushotham
authors: David
authors: D
authors: Robinson
authors: Henrik
authors: H
authors: Møller