While overtreatment of small/preinvasive breast lesions is a problem, it is incorrect to say that improvements in breast cancer survival are due to screening that picks up lesions that were previously not detected.
*"From 1975 to 2010, the mortality of breast cancer declined from 32 per 100,000 per year to 21 per 100,000 per year (34%). At the same time, the incidence increased by 30%, in particular for localized breast cancers (62%) without a commensurate decline in the number of regional breast cancers. From 1975 to 2002, 10-year survival increased by 28% (from 64.9% to 82.8%). The increase in survival was greater for regional cancers (23%), than for localized (10%) or for distant cancers (3%).
The decline in breast cancer mortality in the USA from 1975 to 2010 is unlikely to be the result of advances in prevention or screening. The large increase in the incidence of localized cancers without a corresponding decrease in advanced breast cancers suggests a prominent stage shift, due to overdiagnosis. The drop in the mortality rate could be accounted for by an improvement in cancer survival, likely due to increased use of adjuvant chemotherapy over the period."*
Survival is improving even for patients with advanced stage breast cancer:
I’ve wondered about the OP’s question as well. Just today I saw a sign (decal, magnetic ribbon, I didn’t pay enough attention) that simply said, “Cancer Awareness”.
Who’s not aware of cancer?
Relatedly, who’s not aware of autism? Or any of the half dozen other awareness programs.
To me, it’s nothing but a feel good campaign. “Look! I’ve done my part by buying a decal and put it on my car! Go me!” You can’t put enough information on a bumper sticker detailing what they’re actually doing with the money they raise, I suppose. So we’re left with the short little stickers that make sure we’re aware of things we’re already aware of.
There are no advances in prevention or screening, i.e., there’s nothing new being done, simply more of the same.
Stage shift means that cancers are being detected earlier and simply that moves the 5 or 10-year survival a lot. It also catches women with breast cancer that die or other causes.
Increasing the use of chemotherapy is not really breaking new ground, even if it’s done better.
Stage 4 survival is increasing, but it’s from 20 to 26 months (median); everything we treat is getting better; although a better understanding of the immune system and genetics is certainly at play, but it also work for all cancers. However, Stage 4 means that 75% will be dead in 5 years.
Breast cancer treatment has improved (I overstated the “nothing”) but a lot of money and impetus still goes to two techniques of which one definitely doesn’t work (self-examination) and one that almost certainly does little to increase survival (mammograms).
We don’t need more awareness, we need less. We need fewer women worried about breast cancer (except for those with clear genetic chances) because it doesn’t help them in living more.
Similarly, the campaigns for breast cancer “awareness” aren’t in the main about awareness of the disease itself, but the steps or activities you personally can take to fight it. In some cases they’re reminders for screenings. in some for donations or purchases that give a piece of the sale to research. Other people get reminded of the runs or walks or whatever and the need to sign up, get sponsors, etc.
I had no idea economics was so insulating. Do you deny that there are a limited number of resources that can go to cancer research/treatment? Do you deny that breast cancer gets a disproportionate amount of those resources? Do you deny that curing a child’s cancer will result in more years of post cancer life?
I have thought that it might be more worthwhile to spend the marketing effort to raise awareness among researchers to try to convince them to spend more of their time on researching potential breast cancer cures and less time on observing marsupial mating practices or digging up bones in the Middle East. Would this work?
