Page last updated at 06:40 GMT, Wednesday, 24 September 2008 07:40 UK

Breast cancer 'kills more poor'

Mammography
The deprivation gap widens over time

Breast cancer is more likely to kill poor women than their more affluent counterparts, research shows.

A study of breast cancer patients in England and Wales diagnosed between 1986 and 1999 found overall long-term survival rates are improving.

However, survival rates one year after diagnosis were worse among poor women than those who were more affluent.

And the British Journal of Cancer study found this "deprivation gap" doubled five years after diagnosis.

The inequalities in breast cancer survival between richer and poorer women that have been identified are of great concern
Dr Sarah Cant
Breakthrough Breast Cancer

The study, which looked at more than 380,000 women, found that even after adjustijng for other causes of death, the five-year survival rate was about 6% higher for affluent women.

The figures are part of a detailed analysis of survival rates for the 20 most common forms of cancer.

The researchers found that one-year survival rates tended to be higher among affluent women across a range of cancers.

However, breast cancer was the only form of the disease for which this deprivation gap continued to widen years after diagnosis.

Lead researcher Professor Michel Coleman, an epidemiologist for Cancer Research UK, said women from poor backgrounds might be less likely to access radiotherapy or drug treatment.

Others said the key could be that patients living in deprived areas were more likely to be diagnosed at a late stage, or to have other life-threatening diseases.

Improvements

Dr Sarah Cant, of the charity Breakthrough Breast Cancer, said there had been significant improvements in access to services and treatments since the 2000 Cancer Plan which would not be be reflected in the study.

However, she said: "The inequalities in breast cancer survival between richer and poorer women that have been identified are of great concern.

"It is vital to continue to investigate the exact causes of any inequalities so appropriate measures to tackle them can be taken."

Professor Mike Richards, National Cancer Director for England, said there tended to be a difference of opinion between clinicians and epidemiologists about the reasons for a deprivation gap.

He said: "In general clinicians were likely to attribute the deprivation gap in survival mainly to the fact that people from poorer backgrounds had other diseases as well as cancer.

"By contrast statisticians put more emphasis on late diagnosis in deprived groups as a cause for poorer survival.

"These differences of opinion highlight the need for high quality information on the details of cancer staging and additional diseases to be collected by clinical teams and made available to the cancer registries."

For most cancers survival up to 10 years has improved significantly between those diagnosed in the mid 1980s and the late 1990s.

But there was almost no change in survival for lung, pancreatic, cervical and bladder cancer.



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