There is an ongoing trope that somehow that cancer incidence and cancer mortality has increased substantially over the past few years. Yet, despite that fact that the myth has been shown to be false, it persists, especially around the pseudoscience complementary and alternative medicine world. And now, we have more good news about cancer – the breast cancer mortality rate has dropped by 40% over the past 30 years.
I’m not sure why a lot of people think that cancer is more prevalent today. Maybe it is because of social media, we hear about it more. Maybe it is because of better diagnostic techniques, we think that the cancer situation is worse. Maybe it is that there is an over reliance on anecdotes about cancer. Finally, maybe it is people who think our bodies are being assaulted by cancer causing GMOs (not cancer causing), vaccines (which prevent cancer), or gluten (not cancer causing).
Of course, the pseudoscientific pushing alternative medicine world wants to convince you that science based medicine is incapable of treating cancers and only push highly profitable poisons from Big Pharma pushed into cancer patients. Unfortunately for that narrative, the statistically significant drop in the breast cancer mortality rate says that oncologists are doing a good job with a deadly cancer.
Breast cancer mortality – the paper
The study, published in CA: A Cancer Journal for Physicians by CE DeSantis et al., provided an overview of USA breast cancer statistics, including incidence, mortality, survival, and screening. According to the article, breast cancer mortality rates increased by 0.4% per year from 1975 to 1989. However, since 1989, death rates decreased rapidly, resulting in a 39% drop from 1989 to 2015. This translates to 322,600 averted breast cancer deaths in the USA alone.
This study attributed the long-term reduction in breast cancer mortality to both improvements in treatment modalities and early detection by mammography.
Treatment advances included progress in chemotherapy regimens that were developed in the 1980s and have been substantially improved since then. These regimens are administered post-surgery to reduce the risk of recurrence of breast cancer.
These advances in treatment includes tamoxifen, a selective estrogen-receptor modulator that inhibits the increase the growth of breast cells and promote factors that decrease the growth of breast cells; trastuzumab, which is used for breast cancers that are HER2 receptor positive; and aromatase inhibitors.
Of course, there is that trope that Big Pharma is hiding a “cure for cancer” in the basement of Big Pharma headquarters – no, they are not. Apparently, Big Pharma is doing a good enough job providing excellent cancer treatments that the breast cancer mortality rate has dropped by 40% over the past 30 years.
Therefore, we should celebrate the reduction in the breast cancer mortality rate. And we should celebrate the over 300,000 deaths from the disease that was averted.
Breast cancer mortality – the not so good news
The toll of breast cancer remains high despite the remarkable progress in diagnosis and treatment. Breast cancer is still the most common cancer diagnosed in US women. It is also the second leading cause of cancer death (after lung cancer).
During 2017 (pdf), it is expected that there will be over 252,000 new cases of breast cancer diagnosed in the USA, and more than 40,000 women are predicted to die of the disease. To put that into perspective, a woman in the USA has a 12.4% lifetime risk of being diagnosed with breast cancer.
The study also found that there were substantial variations in breast cancer mortality rates for different ethnic groups. For example, in 2015, the mortality rate for black women diagnosed with breast cancer was approximately 39% higher than that for whites. To be fair, that’s a slight reduction from 2011, when black women had a 44% higher breast cancer mortality rate.
The authors off the study concluded that:
A large body of research suggests that the black-white breast cancer disparity results from a complex interaction of biologic and nonbiologic factors, including differences in stage at diagnosis, tumor characteristics, obesity, and comorbidities as well as access, adherence, and response to treatments.
It is clear that black women have not been able to take advantage of the advances in screening and treatment – advances that have benefited white women. For example, the study did mention that black women do not get an advantage from tamoxifen, because they are less likely to have estrogen-receptor positive breast cancer, which is the target of the drug.
However, three states – Connecticut, Delaware, and Massachusetts – showed a statistically significant improvement in reducing (or even eliminating) the racial disparity in breast cancer mortality.
Yes, many of these results presented in this study should be celebrated. The breast cancer mortality rate has dropped by 40% in three decades. The reasons aren’t because of some miracle concoction from your local naturopath – it’s a direct result of improved science in diagnosis and treatment.
Have we conquered breast cancer yet? No one is making that claim, at least on the real medicine side. Do we have a significant disparity in success for different ethnic groups? Yes, but many states are focusing on fixing that issue.
We are winning the war on cancer, at least if you look at breast cancer mortality. But there are over 200 different cancers (possibly many many more), and each cancer enemy in this war requires a different strategy to defeat. Science is giving us the tools and tactics to defeat cancer, and it’s not an instantaneous process. But we’re getting there.
- DeSantis CE, Ma J, Goding Sauer A, Newman LA, Jemal A. Breast cancer statistics, 2017, racial disparity in mortality by state. CA Cancer J Clin. 2017 Oct 3. doi: 10.3322/caac.21412. [Epub ahead of print] PubMed PMID: 28972651.
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