15 ms·
Breast-cancer death rate drops almost 40 percent
- jack9 9y agoMy first thought is that it didn't really save lives. 322k now die of other causes.
- dexterdog 9y agoYou gotta die from something.
- nathancahill 9y agoMe too thanks.
- copperx 9y agoSure. When you die of other causes, you don't die of cancer. This is middle school set theory.
- criddell 9y agoI think you are agreeing with the parent. 300,000+ lives are saved... for now. I've thought about this too. No life is saved, it is only prolonged. If these people have been given an extra five years of life, that must be a pretty spectacular return on investment. Compare how much was spent developing and administering treatment to the value of 1.5 million years of life.
- deleted 9y ago[deleted]
- loco5niner 9y agoThat's true. Hospitals, doctors, vaccines, eating... none of them save lives.
- eru 9y agoAnd that's why we use quality-adjusted-life-years (qaly) as the measure of treatment success. See https://en.wikipedia.org/wiki/Quality-adjusted_life_year https://en.wikipedia.org/wiki/Quality-adjusted_life_year
- paulcnichols 9y agoWhat about the base rate of getting breast cancer? Am I to understand women still get diagnosed at the same rate but the treatment has gotten better? What happened in the 70s that made it so much more common?
- zitterbewegung 9y agoI bet in the 70s it became easier to detect .
- jonsen 9y agoAnd then a period with a lot of false positives.
- Retric 9y agoDeaths from cancer are not subtitle. This is measuring the number of deaths not the rate of early detection.
- thaumasiotes 9y ago"Deaths within 5 years" are strongly affected by when you start the 5 year clock. The earlier you detect cancer, the better your 5-year survival rate will be.
- Retric 9y agoWithout treatment they don't change much. It's detection followed by treatment that changes anything. And discounting early detection as a part of treatment is horribly misleading.
- thaumasiotes 9y agoI'm finding it difficult to imagine how you think this could possibly work. Cancers start small and develop into larger problems over time. Consider a hypothetical patient who develops cancer at the age of 70 and dies of it, untreated, at the age of 78. If the cancer is detected at the age of 75, detection will lower the 5-year survival rate, since the patient dies after three years of "having cancer". If it is detected at 72, detection increases the 5-year survival rate, since the patient now dies after 6 years. Without treatment, early detection has a very strong impact on 5-year survival rates.
- SoulMan 9y agoWondering if there is any global stats outside of US.
- shadykiller 9y agoGood to see the rates dropping but it is disappointing to see that alternative treatment paradigms, like diet and fasting aren't given a serious look. Relevant article: http://www.npr.org/sections/health-shots/2016/03/05/468285545/fighting-cancer-by-putting-tumor-cells-on-a-diet http://www.npr.org/sections/health-shots/2016/03/05/46828554...
- ceejayoz 9y agoThat article seems to indicate they're been given serious looks, and that even their proponents object to the idea of diet/exercise as an alternative: > Even Seyfried acknowledges, despite his zeal for treating cancer by tinkering with calories, that in all likelihood diet and nutrient-based cancer treatments will serve as adjuncts to existing therapies.
- evgen 9y agoAKA "our unsupported fringe theory can't actually survive direct study, but if we can linger in the noise of actual effective treatments then there are more suckers to be bilked"
- lwhalen 9y agoYou know what they call alternative treatments that work? Treatments.
- KekDemaga 9y agoAlternative medicine, the alternative to medicine.
- gwbas1c 9y agoBecause a good diet and fasting do not kill tumors.
- thaumasiotes 9y agoTrust me, if you stick to it, fasting will kill a tumor. No tumor can survive the death of the host.
- mter 9y agoDoes anyone know when we decreased the age for recommended mammograms to 40? My assumption is that it's in the time range of the article. I can only find references to us raising the recommended age to 45 in 2015, controversy over raising it to 50 in 2009 and how there are diverging opinions on when they should be done.
- sjg007 9y agoI think brca status matters more as that classified high risk.
- astura 9y agoThe GP is asking about recommendations for routine screening in asymptomatic women at average risk of breast cancer. Screening and/or prophylactic treatment for high risk women is a different topic entirely and probably highly individualized.
- tu7001 9y agoSwitzerland bans mammography.
- wozer 9y agoThey stopped recommending screening. But they did not ban mammography.
- evolve2017 9y agoThis is very controversial - in short, there is no national recommendation for mammogram screening to start at 40 years. Multiple professional organizations disagree (see below). For the societies that recommend age 45, they suggest that concerned women speak with their doctor regarding earlier screening. Importantly, note that screening looks for signs of a disease in asymptomatic, normal-risk individuals. The presence of a family history or a lump/mass moves one from the category of screening into that of diagnosis. Age 40: https://www.acr.org/About-Us/Media-Center/Press-Releases/2015-Press-Releases/20151020-ACR-SBI-Recommend-Mammography-at-Age-40 https://www.acr.org/About-Us/Media-Center/Press-Releases/201... - College of Radiology https://www.acog.org/About-ACOG/News-Room/News-Releases/2017/ACOG-Revises-Breast-Cancer-Screening-Guidance--ObGyns-Promote-Shared-Decision-Making https://www.acog.org/About-ACOG/News-Room/News-Releases/2017... - America College of Gynecology Age 45: http://jamanetwork.com/journals/jama/fullarticle/2463262 http://jamanetwork.com/journals/jama/fullarticle/2463262 - American Cancer Society Age 50: https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening#Pod2 https://www.uspreventiveservicestaskforce.org/Page/Document/... - United States Preventive Services Task Force
- FireBeyond 9y agoNow perhaps we can start work on prostate cancer. Not as marketable a topic as prostate cancer. Breast cancer receives half a billion dollars more funding for research than does the latter, despite the latter being more common: http://dailycaller.com/2010/10/05/breast-cancer-receives-much-more-research-funding-publicity-than-prostate-cancer-despite-similar-number-of-victims/ http://dailycaller.com/2010/10/05/breast-cancer-receives-muc... I'm loathe to link to the Daily Caller, but it's a pretty neutral piece with no politics, nonetheless: https://prostate.org.nz/2014/01/men-die-earlier-womens-health-gets-four-times-funding/ https://prostate.org.nz/2014/01/men-die-earlier-womens-healt...
- paulpauper 9y agobut the prognosis for prostate cancer is very good though (except for African Americans, in which it is markedly lower). How about lung, pancreas, esophagus, and stomach cancer But perhaps more research for breast cancer will lead to better treatments for all cancers , even if the focus on one cancer is excessive
- chowyuncat 9y agoIsn't this because prostate cancer is already far less deadly at this point? Both by rate and absolute numbers. Most men will get prostate cancer if they live long enough and we are constantly improving treatment.
- vkou 9y agoAnd more importantly, most men with prostate cancer will die of something that isn't prostate cancer.
- j_s 9y agoNot to derail the entire discussion, but what is the current best practices regarding treatment for prostate cancer? Is there anywhere to keep up-to-date on this specific topic, if it is indeed nearly inevitable?
- Ibethewalrus 9y ago
- stevenwoo 9y agoI don't know much about statistics - can someone tell me why five year survival rates are always used for cancer? This seems kind of off, that instead one should be using the average or median age to which one is expected to live versus how long a cancer survivor lives. Five years seems most misleading when applied to children that get cancer.
- klodolph 9y agoThe streetlight effect? If you want to measure median age, you're not going to get the data for a while.
- neves 9y agoThese studies are darn expensive. To track people for 10 years would almost double the cost of it. Maybe even greater is the opportunity cost. If you have a good result, it would take the double of time for the society to benefit from it.
- incongruity 9y agoWarning: not an expert. Someone smarter/better educated, correct me (or better, tell me I'm right =) Cancer tends to (though not always) correlate with age when you break it up by type of cancer. For example, children don't get prostate cancer or lung cancer all that often. Similarly, Retinoblastoma and other types of cancer are more common amongst children. So, because of that, you have a built-in tendency to control for age and allow the 5-year statistic to be more of a valid comparison. Similarly, you can calculate 5 year survival rates for any set of subgroups you want – break it up by age, race, gender, co-morbidity or even cancer variant (many of those are frequently done) and then compare. At some point (usually in pretty quickly) the 5 year survival rate is a meaningful comparison... Also, to be honest/in my opinion, 5 years is a meaningful number for the lived experience. You can imagine doing a lot in five years vs, say, 6 months – so for that reason, it's a useful metric for generally understanding "what chance do I have at having more life to truly live?"
- stewbrew 9y ago5-yrs mortality rates are a questionable statistic, especially when comparing death rates in time. Critics would argue that the lead time (i.e. the time between diagnosis and clinical symptoms) has changed in time due to earlier diagnosis but the effective time of death has not. It's a long winded debate. Breast cancer mostly affects women 45+ -- or younger women with a genetic disposition.
- bandrami 9y agoThis is controversial, because the study everybody was talking about last year[1] concluded that there hasn't been a decrease in the breast cancer death rate over that same period. [1] http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2363025 http://jamanetwork.com/journals/jamainternalmedicine/fullart...
- neolefty 9y agoThat study looks at something else entirely: The relation between screening and mortality. It doesn't say anything about survival rates over time. > Conclusions and Relevance When analyzed at the county level, the clearest result of mammography screening is the diagnosis of additional small cancers. Furthermore, there is no concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the overall rate of death from the disease. Together, these findings suggest widespread overdiagnosis.
- tuxguy 9y agoThe study referenced in the article : http://onlinelibrary.wiley.com/doi/10.3322/caac.21412/full http://onlinelibrary.wiley.com/doi/10.3322/caac.21412/full
- dweekly 9y agoGreat! Now can the people interested in helping fewer women (and men) die of cancer please turn their attention to lung cancer, where there is far better "bang for the buck" on research investment? https://www.cancer.org/cancer/non-small-cell-lung-cancer/about/key-statistics.html https://www.cancer.org/cancer/non-small-cell-lung-cancer/abo... Most people who get and die from lung cancer are not smokers. Like my mom.
- SerLava 9y agoSomeone should probably run charity drives for something like "non-smoke related lung cancer" research, and then wow, what do you know, it helps smokers also...
- overcast 9y agoWhere does it say most people are not smokers? "Overall, the chance that a man will develop lung cancer in his lifetime is about 1 in 14; for a woman, the risk is about 1 in 17. These numbers include both smokers and non-smokers. For smokers the risk is much higher, while for non-smokers the risk is lower."
- acbabis 9y agoI haven't researched it, but the two statistics could be reconciled if there are fewer smokers than non-smokers.
- DanBC 9y agoSmoking is the main risk factor for lung cancer. In the US about 80% of lung cancers are related to smoking. https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm > Cigarette smoking is the number one risk factor for lung cancer. In the United States, cigarette smoking is linked to about 80% to 90% of lung cancers. Using other tobacco products such as cigars or pipes also increases the risk for lung cancer. [...] > People who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. Even smoking a few cigarettes a day or smoking occasionally increases the risk of lung cancer. The more years a person smokes and the more cigarettes smoked each day, the more risk goes up. It's true that not all lung cancer is caused by smoking.
- lez 9y agoI wonder why iodine is not mentioned in the article, and how much its use has contributed to the rate drop.
- bionicbrian 9y agoHow strange to see this on the day that a friend of ~20 years passed away. Breast cancer. She was 40.
- zrail 9y agoSorry for your loss.
- deleted 9y ago[deleted]