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Surge in Breast Cancer Cases Concerns Advocates

Expected to rise almost 6% in 2002, group predicts

FRIDAY, Jan. 25, 2002 (HealthDayNews) -- Although more women are surviving breast cancer than ever before, experts are troubled by what they see as a worrisome rise in the number of new cases.

The American Cancer Society (ACS) predicts in its annual report, Cancer Facts and Figures 2002, that 203,500 women will be diagnosed with the disease this year, a 5.9 percent increase over last year. Although experts agree that the spike is disconcerting, there is no consensus as to why it is happening.

"There are few [definitive] explanations for the increase in the number of cases that are being reported," says Dr. Ruth Oratz, an associate professor of clinical medicine at New York University School of Medicine. She and Dr. Michael Thun, head of epidemiological research at the American Cancer Society and one of the authors of the new report, believe some of the increase can be attributed to better screening with techniques such as mammography.

"We're finding tumors earlier that would normally be detected at a later age," Thun says. The aging of baby boomers also is causing the numbers to rise, he says.

The society promotes mammography despite a wave of new studies suggesting that the screening doesn't save lives and shouldn't be done routinely. This week, a panel of experts for the National Cancer Institute, agreeing with the findings of the recent studies, reversed course and said annual mammograms may not be the lifesavers they had been thought to be.

Still, President Bush will seek to increase spending for screening for both breast and cervical cancer by $9 million, to $203 million, in the fiscal year 2003 budget.

"Together, breast and cervical cancer took the lives of more than 45,000 American women in 2001," Health and Human Services Secretary Tommy Thompson told a gathering of the Women's Health Summit today in Beverly Hills, Calif. "These deaths occurred disproportionately among low-income women and women who belong to racial or ethnic minorities. By increasing screening rates for at-risk women, we can save lives."

Oratz also suggests that some of the increased cases may be a result of improvements to our diet in the last 50 years. Thanks to better nutrition, girls are menstruating earlier and women are reaching menopause later, and both factors are suspected causes of breast cancer, she says.

But one breast-cancer activist doubts that explanation. Barbara Brenner, executive director of Breast Cancer Action, a grassroots group of women with the disease, doesn't believe the increase is attributable to better screening because the numbers of screenings haven't risen recently. She says there was a large increase in the number of cases being diagnosed in the late 1980s, when mammography came into popular use. But then the number of breast cancer cases leveled off until recently, she says.

Brenner, whose advocacy group believes that not enough is being done about the breast cancer "epidemic," also believes environmental factors may be to blame.

While more than half a million Americans will die from cancer this year, almost two-thirds -- 62 percent -- of those diagnosed with the disease can expect to live at least another five years, the ACS report says. That's up 2 percent from last year and represents a 6 percent increase in survival since 1997.

Breast cancer survival rates are up as well. The five-year survival rate for a woman who has breast cancer that hasn't spread to other parts of her body is 96 percent, up from 72 percent in the 1940s.

But Brenner says a "five-year survival [rate] is a meaningless statistic in breast cancer" because the disease can come back in 10, 15, or 20 years.

Thun agrees that the five-year survival mark probably isn't the best measure of survival from breast cancer. But, he says, the reported survival rates weren't intended to measure breast cancer alone.

He says that to collect information on 10-year survival rates, researchers would need to look at treatments from about 13 years ago. And looking at 13-year-old information wouldn't give scientists an accurate picture because there are so many new developments constantly occurring in cancer treatments, Thun says.

"Five years is a reasonably good marker for long-term survival" for women with breast cancer, says Oratz. She adds that even though breast cancer can recur, it most often returns within five or 10 years.

What To Do

Oratz says each woman "has to look at the things she can control to reduce the risk of breast cancer." Some known risk factors include daily alcohol consumption, postmenopausal obesity, and having children later in life, according to Thun.

Oratz emphasizes that women need to do monthly self breast examinations, and to have an annual mammogram starting at age 50, or sooner if they have a family or personal history of breast cancer.

To download a copy of the American Cancer Society's new report, Cancer Facts and Figures 2002, go to the society's Web site. (To view the report, you'll need Adobe's free Acrobat viewer, which you can download by clicking here.)

To learn more about the risk factors for breast cancer, read this article from the Susan G. Komen Breast Cancer Foundation.

SOURCES: Interviews with Michael Thun, M.D., head, epidemiological research, American Cancer Society, Atlanta; Barbara Brenner, executive director, Breast Cancer Action, San Francisco; Ruth Oratz, M.D., associate professor, clinical medicine, New York University School of Medicine; Cancer Facts and Figures 2002, American Cancer Society; Health and Human Services statement
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