WOMENAID INTERNATIONAL

WOMEN AND CANCER

BREAST CANCER

Breast cancer is, on a world scale, the most frequent cancer among women, with at least 300,000 deaths occurring each year and an estimate of more than 700,000 new cases.  This cancer is predominantly found in North America and northern Europe.  The probability of developing breast cancer between birth and the age of 75 varies from 1 to 12% depending on the country of residence.  The lowest rates are observed in Africa and the highest are among Caucasian women in the USA. 

While some risk factors have been identified, a high percentage of women with breast cancer have no known risk factors other than age.  Reproductive life and hormonal factors are important with increased risks for nulliparity or a late age at first full-term birth, absence of breast feeding, early menarche and late menopause, reflecting in part the role of exposure to endogenous oestrogens.  Similarly, a diet rich in fruit and vegetables and low in saturated fat may be associated with reduced risk.  Obesity and alcohol consumption, on the other hand, are risk factors.  Some environmental agents, such as exposure to radiation, are known.  Others, such as pesticides have recently been incriminated, but their role is not yet clear. 

Familial risk has long been recognised and in the near future genetic markers may become available to enable the identification of individuals at high risk.  In the meantime, it was agreed that the only prevention currently available is screening by a clinician, self breast examination and mammography after the age of 50 which is associated with a 30% decrease in mortality. 

 

CERVICAL CANCER

The malignant tumours affecting women most frequently are breast, cervical, colorectal and stomach cancer.  At present there are almost half a million new cases of cervical cancer a year.  It is believed that there are as many new cases of cervical cancer diagnosed every year as there are of new cases of AIDS in both men and women.  Cancer of the cervix is a disease found disproportionately in women in developing countries and is one of the leading causes of death among women in these countries.  There is a clear socio-economic gradient in the incidence, linking it with poverty. 

Four-fifths of the diagnosed cases of cancer of the cervix are found in developing countries, 92% of the cases occur in women over the age of 35. 

Human papillomavirus (HPV) has been identified as the major aetiological agent for cervical cancer.  This finding has considerable implications for both primary and secondary prevention.  HPV vaccines are under development and HPV typing may increase the efficiency of screening programmes. 

The introduction of well-organised screening programmes based on cervical cytology has resulted in a dramatic decrease in mortality from cervical cancer in developed countries.  However, such programmes have been difficult to organise in developing countries where alternative screening strategies are under investigation. 

Urgent action must include:  

  • Education for early recognition of the symptoms by medical personnel and women themselves; early diagnosis making use of the range of methods available   

  • Screening tests   

  • Increased access to early treatment is the greatest need in developing countries 

  • Good palliative care and availability and use of oral morphine for pain relief. 

Breast cancer is, on a world scale, the most frequent cancer among women, with at least 300,000 deaths occurring each year and an estimate of more than 700,000 new cases.  This cancer is predominantly found in North America and northern Europe.  The probability of developing breast cancer between birth and the age of 75 varies from 1 to 12% depending on the country of residence.  The lowest rates are observed in Africa and the highest are among Caucasian women in the USA. 

While some risk factors have been identified, a high percentage of women with breast cancer have no known risk factors other than age.  Reproductive life and hormonal factors are important with increased risks for nulliparity or a late age at first full-term birth, absence of breast feeding, early menarche and late menopause, reflecting in part the role of exposure to endogenous oestrogens.  Similarly, a diet rich in fruit and vegetables and low in saturated fat may be associated with reduced risk.  Obesity and alcohol consumption, on the other hand, are risk factors.  Some environmental agents, such as exposure to radiation, are known.  Others, such as pesticides have recently been incriminated, but their role is not yet clear. 

Familial risk has long been recognised and in the near future genetic markers may become available to enable the identification of individuals at high risk.  In the meantime, it was agreed that the only prevention currently available is screening by a clinician, self breast examination and mammography after the age of 50 which is associated with a 30% decrease in mortality. 

 

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