As it appeared on medium.com
When I was a young teen, there was a running joke among a group of my friends. One of us might say something silly and another would caution the rest of us,
"See, that's how stories start!"USA Today posted a story late on Tuesday. The screaming headline?
Breast Cancer deaths drop dramatically over 20 years
And that's how stories start, and now we have a game of telephone circulating the internet and social media channels. It's World Cancer Day and here we have a skewed story that is misleading because it only tells half of the story. We need to back things up just a bit to get a more accurate picture of what is really happening.
Using SEER data generation by the NCI which is accurate and reliable, USA Today chose the feel good story instead of the real story. They also chose to preclude men from the statistics adding insult to injury to yet another stigmatized patient population as evidenced by the blog of Oliver Bogler and Men Have Breasts, Too, a documentary now in production. Even CBS shined a light on male breast cancer in an episode of the popular sitcom Mike and Molly.
That's a message for another day. Today, it's about clarifying that headline. For starters, and as usual, it's true but it's also very misleading. Responsible journalists tell the whole story, not just the part of the story they wish to highlight. Thanks, at least in part, to the pervasive culture surrounding breast cancer, we have come to believe we have achieved great success. To which I say (over and over again):
Breast cancer is NOT the great success story it is portrayed to be, it's simply the one that's been best marketed.
USA Today, to begin with, cites a 34% reduction in death. Those numbers, expressed as percentages, mean little to many of us. Does that mean that for every 100 women, 34 won't die? What is the context? Statistics are a funny thing. They can be manipulated to punctuate a point. Thankfully, the numbers the rest of us, their target audience, might understand were inserted immediately after that percentage.
In 2010, deaths attributed to breast cancer were 26.1 per 100,000 women. In 1990, the number of breast cancer deaths was 34 per 100,000. Yes, that's a significant change and those 8 women for every 100,000 amounts to lots of women. I will concede that point despite the fact that I think, given the amount of money that is thrown at breast cancer every single year, we could have made more progress than 8 women. Again, another story for another day. Follow the money. Are we helping those in need with those dollars? Are we doing life saving research with those dollars? OR, is the lion's share of that money going toward awareness campaigns in communities where we no longer need awareness campaigns? You guess. I'll hint. It's behind door number three.
The more important issue with the USA Today piece is the fact that they did not go back far enough to present a true and accurate picture. Interestingly, there is a graphic within the article that show progress from 1975 but the reality? We need to go back to 1970 and take a good look. So let's do it. This is a chart of what went on starting from 1970. The death's per 100,000 look like this:
- 1970 28.4
- 1990 34.0
- 2000 29.2 (This is what we have to show after 30 years??????)
- 2010 26.1
(Note: my stats may be a bit different as I'm choosing Clifton Leaf's numbers from The Truth In Small Doses. He did his homework. All of it. I wrote about it here.)
I have a few observations and then I'll let the chart speak for itself. The spike between 1990 and 2000 is huge. Over the next ten years, between 1990 and 2000, we were basically back to square one (circa 1970). Thirty years between 1970 and 2000 and that number is, for the most part, stagnant.
When we analyze the overall drop in death, we should not be looking at 8 women per 100,000. Let's look at the true picture. From 1970 through 2010, the drop is little more than 2 women per 100,000. That's a big difference from this so-called dramatic decrease from the screaming headlong and it's one that must be noted.
Actually, we were better off in 1970 than in 2000 and that's pretty damn pathetic when we factor in pink ribbons and the money generated from walks and events and merchandising and AWARENESS. Being aware didn't really do too much to save lives, now did it?
The voices of those with metastatic disease, one of whom happens to be my mom, are forgotten. It is their voices that must be heard. It is the needs of this population that are most urgent and when is comes down to it, the success stories are not nearly significant enough. The gains in overall survival time for the metastatic patients remain just slightly better during this same 40 year period. Yes, progress has been made but the gains are incremental at best and apply to those cancers with very specific molecular signatures.
The majority of breast cancers are driven by estrogen and those cancers can and do recur as distant metastases well beyond the magic five year mark. Any one of us diagnosed with breast cancer is potentially one scan away from metastatic disease. Up to 30% of us living with a past diagnosis can, will and do metastasize regardless of the stage at diagnosis. In other words, even if found at stage ZERO, the cancer can recur and turn into a terminal illness with a very poor prognosis.
Frankly, I'm tired of breast cancer being portrayed as the feel good cancer and being held up as a shining example for early detection which works sometimes or even most times but not all the time and that part of the messaging is conveniently left of of every discussion about early detection. It's buzzkill. It detracts from the message that mammograms are unilaterally helping save lives. Mammograms are detecting cancer earlier and earlier thanks to constant improvements being made in imaging devices but early detection is just that. Early Detection. And early detection is not a guarantee.
Look at the numbers, they don't lie. The end game is death and the bottom line is this.
By and large, the number of deaths from breast cancer has remained unchanged since 1970
Fact's don't lie. Friends DO die. Despite the bill of goods we are being sold, this is the reality that is breast cancer. My opinion? A publication so widely distributed and read, a publication like USA Today should tell the whole story or no story. But maybe that's just me.......
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Excellent post! I saw those headlines too and they didn't sit right with me either. Thank you for providing a longer timeframe of statistics to show how little progress has truly been made. It's time to move on from awareness and onto better treatments and that elusive cure everyone is racing around in pink for. The war on cancer, like the war on drugs, has been a dismal failure.ReplyDelete
Excellent comment: "elusive cure racing around in pink" and most especially "dismal failure"
Thank you for the validation. This means a lot to me!!
Thank you for this. Truth and clarity is what you brought. That headline did the exact opposite.ReplyDelete
Thanks, Nancy. There's another article that was JUST posted... citing "statistically significant" decline. NAILS ON A CHALKBOARD..... ARGGGGGG!!!!!!Delete