As we near the end of Breast Cancer Awareness Month, it's time to speak the truth about how the cancer advocacy industry overly hypes and scares the American public about this disease. The much bandied number "one in eight" gives a good window into this.
When I tuned in CBS 60 Minutes the other night, the first advertisement after the opening teasers said:
Marg Helgenberger (CSI: Crime Scene Investigation): "You know what's a real crime, one in eight women will be diagnosed with breast cancer this year. We don't know how to solve it yet, but this "Warriors in Pink" scarf was created to help."
Narrator: "You can make a difference in the fight against breast cancer, visit Fordcares.com"
One in eight this year! The reality is more like one in 813 - a hundred-fold less.
(The National Cancer Institute's SEER program puts out these figures. You can see the table for all cancers here. The numbers are expressed in new diagnosed cases per 100,000 women, and the estimate of 123 new cases per 100,000 translates to one in 813.)
Cancer advocates who are a little more careful than the CSI actor say that the one in eight number means "lifetime risk" of a woman getting cancer. That number is sort of accurate -- but also wildly misleading. If a woman reaches age 85, her cumulative lifetime risk of getting breast cancer (not dying of it) is one in eight. But it's not a number that is useful to anyone.
By age 85, a woman has escaped the risk of early death from breast cancer that so worries everyone. So what is the point of even talking about what an 85-year-old's risk is? Maybe because it's an arresting number, and a lot scarier than the real age-related numbers that count.
Here's a table of the risk of being diagnosed with cancer depending on a woman's age (also from the National Cancer Institute ):
A woman's chance of being diagnosed with breast cancer is:
• from age 30 through age 39 . .. 1 in 233
• from age 40 through age 49 . . .1 in 69
• from age 50 through age 59 . . .1 in 42
• from age 60 through age 69 . . .1 in 29
The chance of dying prematurely from breast cancer is, fortunately, even less. Here's a table giving those odds by age: (these are in five-year increments, also from the government SEER data; click here to see the source data)
• from age 35 through age 39 . .. 1 in 12,987
• from age 40 through age 44 . . .1 in 6,993
• from age 45 through age 49 . . .1 in 4,348
• from age 50 through age 54 . . .1 in 2,980
• from age 55 through age 59 . . .1 in 2,062
• from age 60 through age 64 . . .1 in 1,618
• from age 65 through age 69 . . .1 in 1,372
So the death risk is nowhere close to one in eight.
When you compare breast cancer to the other major killers, you can calculate the likelihood of death in any given year by type of disease.
A woman's chance of dying in any one year (combining women of all ages) is:
• All causes: 1 in 155
• Heart diseases: 1 in 475
• All cancers: 1 in 661
• Lung cancer: 1 in 2,500
• Chronic obstructive lung disease: 1 in 2,777
• Accidents: 1 in 3,876
• Alzheimer's: 1 in 4,016
• Breast cancer: 1 in 4,367
• Diabetes: 1 in 5,128
• Colon cancer: 1 in 6,944
• Pneumonia: 1 in 7,092
(This is based on government "age-adjusted" data from the CDC's last report earlier this year. Here is the table.)
None of this is to say that breast cancer isn't an important worthy target of research and education. It just should not be blown out of proportion with statistics that are very, very far off the mark.
Responsible cancer advocates never use the one-in-eight number because they know how misleading it is. Dr. Susan G. Love says flatly on her website: "The one in eight statistic doesn't accurately reflect breast cancer risk."
Others, however, print up T-shirts with the number, name websites with it, and use it in many other ways, like the PSA on 60 Minutes the other evening.
So maybe it's time to bury this overly scary, misleading number.