Friday, 4 May 2007

Breast cancer awareness

From the University of Oxford news of a study which questioned almost 1500 women and found that they were unaware of the increasing risk of breast cancer caused by age.

They were given a choice of 10-year age bands and had to choose where the greatest risk lay. 99% of the women questioned answered incorrectly, 56% saying age doesn’t matter. Only 0.7% answered correctly that a woman in her 80s had the highest risk.

Age is the strongest risk factor for breast cancer, with the chance being 1 in 25 compared with 1 in 70 for a woman in her 40s. The researchers think that the confusion is partly the “Kylie” effect of publicity for younger, well-known women who have been diagnosed, and partly because routine screening is offered only up to the age of 70 in the UK, even though an older woman can request an appointment.

The study was funded by Cancer Research UK and the Breast Screening Programme.

When you couple this with the very recent report from the University of Manchester which highlights a lower level of care for older women, things start to look very depressing for older women. They are likely to present late, and receive worse care when they do. The Manchester study found that women over 80 compared with women between 60 and 69 are less likely to:

  • have a triple assessment (clinical evaluation, imaging, cytology/histology)
  • receive surgery
  • have a steroid receptor test to assess the efficacy of tamoxifen
  • if they do have surgery they are less likely to have radiotherapy

The main drawback of this study would seem to be that they didn’t take into account the preferences of the patients which may have a considerable bearing on the results, but with the population aging as it is, and with people staying fitter and more active longer, it is important that women realise that they are at increased risk and do continue to be vigilant, and that they receive the care and attention they need if they do need treatment.

I do believe, at least among the general public, there is an attitude that sees disease in old age as inevitable and hardly worth treating. I remember when my father in law died from a heart condition people were inclined to shrug as if to say, “well he’s old” whereas one imagines they would express more concern for a younger person. This must inevitably mean that more money/effort will go to charities funding research into areas which are perceived as problems for younger people, breast cancer included it seems. I recently came across someone who had been for a cervical smear test and had met a woman there in her eighties. To my horror my acquaintance expressed surprise and said “at that age, why bother?”

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