Breast cancer

Major report outlines how to cut breast cancer inequalities: one quarter of cases still preventable

A major new report into global breast cancer has identified improving healthcare professionals’ communication skills and investing in tools to capture the hidden costs of the disease as ways of tackling health inequalities.

The Lancet Commission, led by the University of Cambridge’s Professor Charlotte Coles, shows that the associated costs of breast cancer are under-recognised. This includes everything from physical and psychological costs, to social and outright financial costs.

The report explored serious health-related suffering (SHS) – an indicator of the need for palliative care.

Based on the 685,000 women who died from breast cancer across the world in 2020, it was projected that 120 million days were spent with SHS per year for those who died of their cancer. Patients also spent an estimated 520 million days living with their disease.

Researchers also set up the CASCARA UK-based pilot – funded by the National Institute for Health and Care Research (NIHR) – to further explore the economic burden and care costs for people with breast cancer. Almost all of the 606 people surveyed reported physical or wellbeing issues.

The commission is therefore calling for new tools to better understand the cost associated with breast cancer. This newfound data would lead to policymakers hopefully investing in:

  • Breast cancer prevention
  • Early detection
  • Cost-effective therapy
  • Optimal management
  • Financial protection

Charlotte, who is also an NIHR research professor, said: “Our Commission builds on previous evidence, presents new data, and integrates patient voices to shed light on a large unseen burden.

“We hope that, by highlighting these inequities and hidden costs and suffering in breast cancer, they can be better recognised and addressed by health care professionals and policymakers in partnership with patients and the public around the world.”

The authors also call for 100% of healthcare professionals to receive communications skills training, as better conversations with patients could improve quality of life, decision-making, body image, and adherence to therapy. Patients should be involved in all stages of clinical research too.

According to the commission, up to one-quarter of breast cancer cases in high-income countries could be prevented by modifying risk factors like alcohol consumption, being overweight and physically inactivity.

Identifying people at an increased risk will support equitable access to personalised prevention plans.

The number of people living with metastatic breast cancer is unknown globally, so the authors also argue that 70% of registries across the world should record the cancer stage and relapse, which could significantly improve care for metastatic breast cancer.

Image credit: iStock

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NHE May/June 2024

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