Medical science hasn’t served women as well as it could
In 40 years cancer survival rates have doubled but not everything is rosy — especially if you are fe
In 40 years cancer survival rates have doubled but not everything is rosy — especially if you are female.
On first hearing, it sounds like bad news. This year, around 717,000 men and 566,000 women in the European Union will die from cancer. However, adjusted for population changes, the death rates from cancer will be down 10 per cent in men and 7 per cent in women from 2007 levels.
These cheering figures were published in the Annals of Oncology last week. It's important to register the success of our fight against cancer. According to a survey carried out for Cancer Research UK in 2010, one-fifth of us fear getting cancer more than we fear debt, knife crime, Alzheimer's disease and losing a job. It may be that in 2012 the likelihood of getting into debt or losing a job has risen, but when it comes to cancer there is definitely reason to be, if not exactly cheerful, at least a bit less pessimistic.
In the past 40 years cancer survival rates have doubled. Nearly three-quarters of children with cancer are now cured; in the 1960s, three-quarters died. The reason? Basic research: improved diagnosis and treatments, and the development of nationwide screening programmes for breast, bowel and cervical cancers.
Not that everything is rosy – especially if you are female. That 3 per cent discrepancy between improved mortality for men and women is telling. Medical science hasn't served women as well as it could.
There is controversy over breast cancer screening, for instance. Though screening programmes are clearly useful for picking up cancers early, many clinicians are concerned about the rate of false positives. In October last year, a review found that 2,000 screeenings over a ten-year period would save one life, but ten women would have unnecessary treatment and 200 would undergo months of severe psychological trauma because of a misdiagnosis.
Cervical cancer screening is also under scrutiny. Research published this month in the British Journal of Cancer suggests the invasive and distressing cervical smear test might be better used only as a follow-up to a positive result for the less distressing human papillomavirus test.
Perhaps the most stubborn problem facing women and cancer is that the medical research establishment doesn't seem to like dealing with the female sex – even in its laboratory animals.
Most lab mice are male, even when researchers are using them to investigate diseases that are more likely to affect women. This is partly because male mice are cheaper but mostly because of a persistent but mistaken belief that female hormone variability will affect the results of experiments.
Women are also under-represented in clinical trials; a 2009 study showed that less than 40 per cent of cancer trial subjects are women. Take into account that several cancers manifest and should be treated differently in women, and that the side effects of some cancer drugs are more severe for women, and it's clear that something is amiss.
A final piece of bad news for women: last week's report suggests that female lung cancers will rise by up to 7 per cent this year. The best way to fight this trend is to introduce measures that will deter young girls from taking up smoking, and one of the easiest options for this will come into view in the next few weeks. The government is about to launch a public consultation on tobacco packaging.
A wealth of studies shows that young people are far less interested in smoking when cigarette packaging is stripped of all branding. Since the vast majority of smokers today started as teenagers, introducing plain packaging would be good news for everyone.
Michael Brooks's "Free Radicals: the Secret Anarchy of Science" is published by Profile Books (£12.99)