Rich-poor gap widens in breast cancer survival

There is a "worrying" gap between the number of affluent women surviving breast cancer compared with those from deprived backgrounds, research suggested today.

Although long-term survival continues to rise among women from all social classes, the gap between rich and poor still persists.

One year after diagnosis, survival rates were lower for breast cancer patients from deprived backgrounds than those from affluent backgrounds.

And five years after diagnosis, this "deprivation gap" had doubled.

Cancer charities described the findings as "of great concern", and the Government acknowledged that "there was still more to be done".

The study, published in the British Journal of Cancer, looked at more than 380,000 women who were diagnosed with breast cancer in England and Wales between 1986 and 1999.

Even after adjusting for other causes of death, the five-year survival of women with breast cancer who lived in the most affluent areas was around 6% higher than for women from deprived areas.

The study noted that the gap also exists for many other types of cancer.

However, this gap does not generally widen between one and five year survival rates, suggesting breast cancer is the exception.

Professor Michel Coleman, a Cancer Research UK epidemiologist, said one reason why the gap may widen over time is due to lower take-up of radiotherapy among women from deprived backgrounds. This leads to a higher risk of late recurrence of breast cancer.

Problems accessing chemotherapy or hormone therapy and differences in accessing the life-prolonging drug tamoxifen may also have been a contributory factor for women diagnosed in the late 1980s and early 1990s, he said.

Dr Sarah Cant, policy manager at Breakthrough Breast Cancer, said: "It's important to remember that there have been significant improvements in access to services and treatments since the 2000 Cancer Plan which won't yet be reflected in this study.

"However, the inequalities in breast cancer survival between richer and poorer women that have been identified are of great concern and it's vital the exact causes of any inequalities are now investigated so appropriate measures to tackle them can be taken."

A spokesman for the Department of Health added: "The inequalities gap between the most deprived groups and the general population has been reduced considerably over the past decade.

"Between 1996 and 2005 the gap in the cancer mortality rate was reduced by 11.3%. However there is still more to be done.

"The Cancer Reform Strategy, published in December 2007, included a number of initiatives aimed at reducing inequalities in cancer.

"The National Awareness and Early Diagnosis Initiative is currently improving awareness of the signs and symptoms of cancer while The Improvement Foundation is currently undertaking pilots in some of the most deprived areas in the country to target those most at risk of developing cancer.

"We are also aiming to achieve a world-class radiotherapy service and are currently expanding our services."