Breast cancer mortality has not declined in women over 85

Since 1992 the number of deaths linked to breast cancer in Spain has decreased among young and middle aged patients but not among the elderly. Spanish researchers also predict that it will continue to decline over the next decade, although more slowly as observed up until now.

A new study headed by a team of Spanish researchers has analysed breast cancer mortality in Spain among different age groups from 1981 to 2007, setting a valid prediction up until 2023.

Studying this age-related tendency is interesting because any improvement could have significant social and economic consequences, especially in terms of the development of specific health plans.

"We used the Lee-Carter model to examine the data. This model is normally used to study general mortality but rarely employed to study mortality as a result of specific causes," as explained to SINC by Alejandro Álvaro Meca, lead author of the study and researcher at the department of Preventative Medicine and Public Health at the Rey Juan Carlos University in Madrid.

Published in the 'Public Health' journal, the results confirm that associated mortality increased with age, whereas in the different age groups it has decreased over time. The study shows an increase in breast cancer mortality in Spain from 1981 to 1992 and then a decrease from 1993 to 2007.

This could be due to the global increase in mammographies in women over the age of 45, which has increased early diagnosis and improved survival rates as a result.

"The new results support this assumption: there is an evident decrease in breast cancer mortality in women under the age of 50," state the authors.

A slower decrease for the future

The last stage of the Lee-Carter model involves predicting mortality in the future: up until 2023 in this case. Álvaro Meca suggests that the death rate will decrease but will not be so marked as in the past.

"Predictions show that rates will decrease more slowly. Mortality will decrease in all age groups but will not be the same for all. A more significant decrease will be observed amongst the youngest women, with a great difference in middle aged women where stabilisation is predicted and then even an increase amongst elderly women (85 years or over)," adds the researcher.

The results fall in line with those of other studies conducted in Spain. However, research studying mortality in age groups is still scarce.

"Although this decrease trend will continue into the future, everything points to a stabilisation in mortality for elderly women," points out Álvaro Meca. "Therefore, breast cancer preventative practices should be different and specific to the age range of the patient," he concludes.

The reason behind this tendency

Breast cancer incidence has increased in all European countries in recent years, independently of whether or not national screening programmes are in place. However, mortality has experienced an annual decrease of 1.8% from 1997 to 2006.

This tendency is due to mammographies and the application of effective hormone treatments, chemotherapy and advances in radiotherapy and surgery.

According to Spain's 2006 National Health Survey, 4% of women between the age of 25 and 34 and 19% between the age of 35 and 44 undergo a mammography every two years.

"It is probable that such innovation has contributed to improved breast cancer survival rates observed in Europe, although the contribution of each factor is unknown," indicate the authors.