The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women.
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.
Department of Health Sciences, University of Leicester, Leicester LE1 7RH UK.
M J
MJ
Rutherford
Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.
G A
GA
Abel
1] Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK [2] National Cancer Registration Service, Public Health England, Eastern Office, Cambridge CB22 3AD, UK.
D C
DC
Greenberg
1] Department of Health Sciences, University of Leicester, Leicester LE1 7RH UK [2] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stocholm SE-171 77, Sweden.
P C
PC
Lambert
1] Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK [2] Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, UCL, 1-19 Torrington Place, London WC1E 6BT, UK.
G
G
Lyratzopoulos
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D015331:Cohort Studies; D004739:England; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D012959:Socioeconomic Factors; D015996:Survival Rate