Better screening for breast cancer, treatments may have saved hundreds of thousands of lives for 30 years

By linda carroll

(Reuters Health) – In the past three decades, screening and improved treatments have prevented hundreds of thousands of women from dying from bad cancer, computer simulations suggest.

According to the researchers at Cancer, according to the simulation, between 305,000 and more than 600,000 deaths from bad cancer could have been prevented.

Because no one knows how many women could have died without advances in detection and treatment, the authors of the new study developed estimates of bad cancer trends based on information gathered before 1990.

"The number of women per 100,000 who died every year between 1975 and 1990, before the widespread implementation of the screening test, increased slightly from one year to the next," said study co-author Dr. Jay Baker, professor of radiology at Duke University and head of the mammary image at Duke University Hospital. "There are several badumptions you can make about the maximum mortality rate, for example, you could say it would have been flat after 1990 or it could be said to have continued to rise at the same pace it was between 1975 and 1990, or I could say it was increasing more what's that? "

For the new study, Baker and her colleagues turned to data from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute to estimate how many women between the ages of 40 and 84 were dying of bad cancer each year before and after 1989. SEER collects data on cancer diagnosis, treatment and survival in approximately 30 percent of the US population. UU

First, they hypothesized four ways in which the story could have happened if there had been no progress in detection and treatment. (For example, the number of deaths from bad cancer remained constant after 1989, or mortality rates increased by 0.4 percent per year since 1989, etc.)

Then, they subtracted the annual number of deaths calculated from the SEER data of the number of deaths predicted in their simulations. The resulting number, Baker said, was the number of deaths averted.

Depending on which scenario they used, the number of deaths from bad cancer avoided between 1990 and 2018 ranged from 305,000 to 614,500.

The new findings should be interpreted in light of the number of badumptions used in the researchers' calculations, said Dr. Deanna Attai, an badistant clinical professor in the department of surgery at the David Geffen School of Medicine at the University of California, Los Angeles. Angels Los Angeles and UCLA Health Burbank Breast Care.

Another weakness of the study is that the SEER data were only available until 2015, and the researchers used that information to estimate mortality rates in the future.

"I do not think any of us would doubt the badumption that improvements in detection and improvements in treatment have led to better results," said Attai. "But you have to consider the fact that they do not have real data for 2016, 2017 and 2018. And you have to keep in mind that the SEER database does not include all the women who died of bad cancer."

While the SEER database is very useful, over the years it has changed to include more parts of the country and minorities, said Attai. That means that sampling 20 years ago may differ from the most recent years.

Beyond that, said Attai, there is no information in the SEER database about whether women had a mammogram within a year of being diagnosed with bad cancer. Therefore, it is impossible to say, based on this database, what impact the evaluation had on decreases in deaths.

"Studies like this are, at best, guestimates," said Attai.

"I'm more interested in the years 2017 to 2019, since that's when there have been tremendous advances in targeted therapies," he said.

SOURCE: Cancer, online February 11, 2019.

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