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Breast cancer death rate falling Apr. 11, 2007 Progress in detection and treatment of breast cancer over the past 20 years has reduced the death rate from the disease by 25 per cent, the Canadian Cancer Society says. About one in every 100 Canadian women has now survived breast cancer, according to a new report from the CCS. It says the age-standardized death rate has fallen to about 22 cases per 100,000 from 30 since 1986, a drop of 25 per cent, and that 86 per cent of women now survive at least five years after a diagnosis. The burgeoning community of pink-ribboned survivors — 162,600 and counting, roughly the population of Prince Edward Island and Nunavut combined — is a testament to the effectiveness of early detection through better screening and better treatments that stave off recurrence, CCS director of cancer-control policy Heather Logan said. “We're making progress and it's important for women to hear that we're making progress,” Ms. Logan said. “ ... If we can diagnose earlier, we can treat more successfully.” But breast cancer continues to take a significant toll. An estimated 22,300 women will be diagnosed with the disease in Canada this year, and about 5,300 will die because of it, according to the report. In 1986, about 12,000 were diagnosed and 4,700 died of it. The breast cancer incidence rate in Canada is among the highest in the world, the report notes. The same as most malignancies, breast cancer is due to a combination of genetic, environmental and lifestyle factors. Carrying the so-called breast cancer genes — mutated BRCA1 and BRCA2 — poses the greatest risk. A number of reproductive/hormonal factors come into play, such as early menstruation, a woman's age when she gives birth, late menopause and using birth control pills or hormone replacement therapy. Lifestyle behaviours including physical inactivity, obesity and alcohol consumption also increase risk. Because breast cancer is not entirely preventable, catching it early is key. But Ms. Logan said the number of women being screened for breast cancer is still far from optimal. The cancer society recommends that women aged 50-69 undergo a mammography — an X-ray of the soft tissue inside the breast — every two years. Between 34 and 61 per cent of women are actually following that advice, according to published studies. The rest are not. “We need more women to get into a screening program,” Ms. Logan said. Jane Hawley, a Toronto educational assistant, went to the doctor for a routine checkup in 2003 and her doctor suggested a mammogram. “Initially, I said no,” she recalled in an interview. “I figured I was wasting time, that there were certainly people sicker than me.” But the doctor insisted and the mammogram revealed a small lump that turned out to be cancerous. Ms. Hawley had surgery, then radiation and chemotherapy. Today, at age 57, she is cancer free and in good health. “I'm extremely thankful there is a mammogram. The test saved my life,” she said. “I know a lot of women, like me, couldn't be bothered. But I hope my story will change their minds.” Ms. Hawley said that while the mammogram is uncomfortable, the discomfort needs to be kept in perspective. “There's nothing more unpleasant than cancer. ... The test is not so bad in comparison.” She benefited not only from early detection but from new treatments. Chemotherapy is now more targeted and less toxic. And drugs including tamoxifen (trade named Nolvadex) and trastuzumab (Herceptin) are helping prevent recurrences. The new report, entitled Canadian Cancer Statistics 2007, includes a wide range of data. An estimated 159,000 Canadians will be diagnosed with cancer this year, and 72,700 will die. The biggest cancer killer, by far, is lung cancer, followed by colorectal, breast, prostate and pancreatic cancers. There are more than 200 types of cancer. The report notes that while the total number of new cancer cases and deaths continues to rise steadily as the population ages, age-standardized rates — the number of people per 100,000 population — of cancer incidence and death rates are actually falling. Death rates from cancer overall and most types of cancer have been falling for about a decade, with the exception of lung cancer in women and liver cancer in men. An estimated 39 per cent of Canadian females and 44 per cent of males will develop cancer during their lifetimes, according to the report. About 24 per cent of women and 28 per cent of men will die of cancer. Source : TheGlobeandMail |