Cancer Research UKAug 12 2010

Breast cancer death rates have fallen steeply in the UK in the last 20 years - and at a faster rate than in any other European country except for Iceland, a new study in the British Medical Journal has found.

The research challenges previous claims about the UK's cancer services, which were based on poor survival rate in comparison to other western European countries.

A team of scientists at the International Prevention Research Institute in France studied data on breast cancer mortality rates in women living in 30 European countries between 1980 and 2006. World Health Organisation data were used to calculate mortality rates for all women by age group.

From 1989 to 2006, breast cancer mortality decreased by at least 20 per cent in 15 European countries.

The figures show that mortality rates fell by about 30 per cent in the UK - more than in any other country in Europe except for Iceland.

Rates fell by between ten and 16 per cent in France, Finland and Sweden, where significant resources have been invested in breast screening and new cancer drugs.

Meanwhile, mortality rates did not decline in central European countries and some have even seen an increase in the past two decades.

The study authors suggest that this improvement may be due to high rates of breast screening, the use of effective drugs such as tamoxifen, and the reorganisation of breast cancer services.

Writing in an accompanying editorial, Professor Dame Valerie Beral and Professor Sir Richard Peto, from the University of Oxford, point out that the way in which cancers are registered in the UK is imperfect and that the data are therefore incomplete.

Because of this, cancer survival rates may seem significantly worse than they really are, explaining why previous reports have suggested that the UK performs relatively poorly compared to its European neighbours.

Rates of breast cancer have also risen faster in other countries compared to the UK, largely due to a growing proportion of small cancers with a good prognosis. This could also have skewed differences in survival.

In contrast, population-based mortality rates in middle age are reasonably reliable, as the registration of death is complete and deaths from breast cancer are well-recorded.

Professors Beral and Peto concluded that previous failures to take into account the shortcomings of cancer registration data "may well have led to misleading claims about the supposed inferiority of UK cancer treatment services in general".

Hilary Tovey, Cancer Research UK's policy manager, said: "This research highlights the great progress we've made in reducing deaths from breast cancer over the past 20 years.

"The UK has seen greater decreases in the number of women dying from breast cancer than many other European countries over this period, though this is partly because death rates were relatively high in the 1980s.

"Reorganising breast cancer services, screening, improved awareness and better treatments, made possible as a result of excellent research, have all had a role to play.

"In order to make accurate comparisons between cancer survival in different European countries, we must measure like with like. For more meaningful comparisons, improved cancer registration is needed."