Document Detail

Retrospective study of reasons for improved survival in patients with breast cancer in east Anglia: earlier diagnosis or better treatment.
MedLine Citation:
PMID:  9056796     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To investigate the recent fall in mortality from breast cancer in England and Wales, and to determine the relative contributions of improvements in treatment and earlier detection of tumours. DESIGN: Retrospective study of all women with breast cancer registered by the East Anglian cancer registry and diagnosed between 1982 and 1989. SUBJECTS: 3965 patients diagnosed 1982-5 compared with 4665 patients diagnosed 1986-9, in three age groups 0-49, 50-64, > or = 65 years, with information on stage at diagnosis and survival. MAIN OUTCOME MEASURES: Three year relative survival rates by time period, age group, and stage; relative hazard ratios for each time period and age group derived from Cox's proportional hazards model, adjusted for single year of age and stage. RESULTS: Survival improved in the later time period, although there was little stage specific improvement. The proportion of early stage tumours increased especially in the 50-64 year age group, and adjustment for stage accounted for over half of the improvement in survival in women aged under 65 years. CONCLUSION: Over half of the drop in mortality in women aged under 65 years seems to be attributable to earlier detection of tumours, which has been observed since the mid-1980s. This could have resulted from an increase in breast awareness predating the start of the breast screening programme.
D Stockton; T Davies; N Day; J McCann
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  314     ISSN:  0959-8138     ISO Abbreviation:  BMJ     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-04-01     Completed Date:  1997-04-01     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  472-5     Citation Subset:  AIM; IM    
Department of Community Medicine, Institute of Public Health, University of Cambridge.
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MeSH Terms
Age Distribution
Breast Neoplasms / diagnosis,  mortality*,  therapy
Child, Preschool
England / epidemiology
Infant, Newborn
Middle Aged
Neoplasm Staging
Proportional Hazards Models
Quality of Health Care
Retrospective Studies
Survival Analysis
Survival Rate
Wales / epidemiology
Comment In:
BMJ. 1997 Jul 19;315(7101):191   [PMID:  9251573 ]
Erratum In:
BMJ 1997 Mar 8;314(7082):721

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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