Delayed diagnosis explains worse breast cancer survival in Europe than U.S.

Breast cancer survival is known to be worse in Europe than in the U.S., and now new research suggests that this is mainly due to the malignancy being diagnosed at a more advanced stage in Europe.

The findings are based on an analysis of data for 13,172 women entered in the Surveillance, Epidemiology, and End Results (SEER) program in the U.S. and for 4478 women entered in the European Concerted Action on Survival and Care of Cancer Patients (EUROCARE) project. Women in both groups were diagnosed with breast cancer between 1990 and 1992.The current results are reported in the December 29th online issue of Cancer and will appear again in the February 15th print edition.Forty-one percent of tumors in the SEER data set were early stage, compared with only 29% in the EUROCARE set, lead author Dr. Milena Sant, from the Istituto Nazionale per lo Studio e la Cura dei Tumori in Milan, Italy, and colleagues note. In the US, such tumors were more common in older women than younger women, whereas in Europe, just the opposite was true.In both data sets, more than 90% of women underwent surgery and around 81% underwent lymphadenectomy, the authors note. However, more lymph nodes were usually evaluated in U.S. patients than in those from Europe.Consistent with previous reports, survival was higher for U.S. patients. The 5-year survival rate in the SEER data set was 89%, whereas the rate in the EUROCARE set was 79%. Overall, European patients were 37% more likely to die than their U.S counterparts.On multivariate analysis, the researchers found that the disease stage at diagnosis accounted for most of the survival difference seen between the U.S. and European groups.”These results suggest that more resources should be invested to achieve earlier diagnosis of breast carcinoma in Europe, especially for elderly women,” the investigators conclude.(Source: Cancer 2003;100: Reuters Health: December 29, 2003: Oncolink)