If you want to begin to understand why breast cancer rates declined so suddenly in 2003 -- and remember we are three years behind the reporting curve -- read Tara Parker-Pope's definitive article in the WSJ:
What Made Breast Cancer Decline in 2003?
The Wall Street Journal
USA, 12/15/2006 - After rising for two decades, the number of women diagnosed with breast cancer fell in 2003 by a stunning 7%.
The reasons behind the steep drop -- which translates to about 14,000 women who didn't get breast cancer that year -- aren't entirely clear. Changes in medication use, including a sharp decline in women taking menopause hormones and increased use of calcium supplements and anti-inflammatory drugs, may all have played a role. A 3% drop in mammography screening among menopausal women in the same year could also help explain why fewer breast cancers were found. "
Yes Virginia, our crazed friends at Breast Cancer Action have done a wonderful job of scaring people away from getting mammographies...
Tara takes on the issue of whether the decline in estrogen use is the sole cause, a view most other articles have been pushing despite the fact that not all breast cancers express the same way:
"One possible explanation for the decline in 2003 is that it is tied, at least in part, to the July 2002 release of the Women's Health Initiative study of estrogen and progestin, which linked the hormones with heart attacks and breast cancer in older women. The WHI, which studied Wyeth's estrogen-progestin drug Pempro, scared millions of women into stopping menopause-hormone therapy almost overnight. Since the WHI announcement, menopause-hormone use has fallen by about 30%."
However...
"While the decline in hormone use between 2002 and 2003 was dramatic, it is unlikely that hormones explain the entire drop because the incidence of ER-negative cancers -- or those that weren't boosted by estrogen -- also declined. As a result, researchers are looking at other changes during the time period that could help explain the overall drop in breast cancer. "
And then there are those horrible COX-2 drugs that David Graham proudly help push off the market:
"Other medications may also have played a role. A separate WHI observational study of more than 80,000 women showed that those who used anti-inflammatory drugs for at least five years had a 20% lower risk of breast cancer. In the U.S., prescriptions for popular anti-inflammatory drugs called Cox II inhibitors more than doubled between 1999 and 2003, according to IMS Health, which tracks pharmaceutical sales data. "
And Graham's lawyer got ticked off because I questioned Graham's judgement?
"Another explanation may be the increased use of the drug raloxifene, which is sold by Eli Lilly & Co. as Evista and was approved for the treatment of osteoporosis in 1999."
In sum, Parker-Pope's multi-factorial analysis is excellent and embodies the gold standard of medical reporting.....
What Made Breast Cancer Decline in 2003?
The Wall Street Journal
USA, 12/15/2006 - After rising for two decades, the number of women diagnosed with breast cancer fell in 2003 by a stunning 7%.
The reasons behind the steep drop -- which translates to about 14,000 women who didn't get breast cancer that year -- aren't entirely clear. Changes in medication use, including a sharp decline in women taking menopause hormones and increased use of calcium supplements and anti-inflammatory drugs, may all have played a role. A 3% drop in mammography screening among menopausal women in the same year could also help explain why fewer breast cancers were found. "
Yes Virginia, our crazed friends at Breast Cancer Action have done a wonderful job of scaring people away from getting mammographies...
Tara takes on the issue of whether the decline in estrogen use is the sole cause, a view most other articles have been pushing despite the fact that not all breast cancers express the same way:
"One possible explanation for the decline in 2003 is that it is tied, at least in part, to the July 2002 release of the Women's Health Initiative study of estrogen and progestin, which linked the hormones with heart attacks and breast cancer in older women. The WHI, which studied Wyeth's estrogen-progestin drug Pempro, scared millions of women into stopping menopause-hormone therapy almost overnight. Since the WHI announcement, menopause-hormone use has fallen by about 30%."
However...
"While the decline in hormone use between 2002 and 2003 was dramatic, it is unlikely that hormones explain the entire drop because the incidence of ER-negative cancers -- or those that weren't boosted by estrogen -- also declined. As a result, researchers are looking at other changes during the time period that could help explain the overall drop in breast cancer. "
And then there are those horrible COX-2 drugs that David Graham proudly help push off the market:
"Other medications may also have played a role. A separate WHI observational study of more than 80,000 women showed that those who used anti-inflammatory drugs for at least five years had a 20% lower risk of breast cancer. In the U.S., prescriptions for popular anti-inflammatory drugs called Cox II inhibitors more than doubled between 1999 and 2003, according to IMS Health, which tracks pharmaceutical sales data. "
And Graham's lawyer got ticked off because I questioned Graham's judgement?
"Another explanation may be the increased use of the drug raloxifene, which is sold by Eli Lilly & Co. as Evista and was approved for the treatment of osteoporosis in 1999."
In sum, Parker-Pope's multi-factorial analysis is excellent and embodies the gold standard of medical reporting.....
