The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women

M J Rutherford, G A Abel, D C Greenberg, P C Lambert, G Lyratzopoulos

Background:Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain.Methods:We analysed data on East of England women with breast cancer (2006-2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70-74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights.Results:For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70-74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population).Conclusions:The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.British Journal of Cancer advance online publication, 3 March 2015; doi:10.1038/bjc.2015.51 www.bjcancer.com.