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Deborah Pettibone
(716) 845-8593
[email protected]

GLOBAL PROGRESS:BREAST CANCER MORTALITY RATES

BUFFALO, NY - The long-term, worldwide trend of increasing breast cancer mortality rates apparently has been reversed in several countries, with significant declines reported in the United States, the United Kingdom and Canada in the 1990s. These are the findings of a study conducted at Roswell Park Cancer Institute by Curtis J. Mettlin, PhD, Department of Cancer Prevention, Epidemiology and Biostatistics, and published in the May/June 1999 issue of CA -- A Cancer Journal for Physicians.

Dr. Mettlin reached his conclusion following statistical analysis of breast cancer mortality rates per 100,000 population, in 41 countries reporting 1,000 or more breast cancer deaths annually, tabulated in the World Health Organization Cancer Mortality Databank.

The overall pattern for breast cancer mortality was found to be one of high rates for Western, industrialized nations, particularly those in Northern Europe and North America, and lower rates for less industrialized and Asian countries. "These differences may be attributable to factors which are thought to be important in breast cancer etiology, such as nulliparity and later age at first live birth, diets high in polyunsaturated fat and other environmental factors," according to Dr. Mettlin.

The decline in breast cancer mortality rates observed in many countries, including the United States, the United Kingdom, Canada, Austria and Sweden, may be due to earlier diagnosis from increased mammographic screening and improved survival from increased use of adjuvant therapy. "The data support and other studies have shown a more general decline in death rates among women diagnosed after 1980," notes Mettlin.

Dr. Mettlin cautioned, however, that the decline in death rates is not seen in all regions. "For example, the favorable trends in Northern Europe are not evident in Spain, Portugal, Greece, Hungary, Poland and Italy. Also, in Japan, where breast cancer death rates have been low, mortality is increasing as the disease becomes more common among Japanese women."

Mettlin feels that viewing breast cancer mortality rates globally reveals interesting features that may not be seen from data from individual countries or regions. "The several-fold difference in risk between countries in North America and Northern Europe compared to Asian regions, for example, suggests that environmental factors may be profoundly involved in the etiology of the disease." He advocates expanding the network of cancer registries and reporting systems that make these observations possible for future monitoring of worldwide progress against the disease.

Roswell Park Cancer Institute, founded in 1898, is the nation's first and one of its largest cancer research, treatment and education centers and is the only National Cancer Institute-designated comprehensive cancer center in Western New York.

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