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Link
Between Breast
Cancer and Social
Status
By
Pat Hagan
LONDON (Reuters
Health) - British breast cancer experts are hoping to find vital
clues as to why social status has a powerful effect on whether
women recover from breast cancer.
In particular,
they want to solve the mystery of why socially deprived women
are less likely than more affluent groups to get the disease in
the first place, yet when they do they are less likely to make
a good recovery.
Cancer specialists
at the Western General Hospital in Edinburgh, Scotland have started
an extensive study to find out if there is any biological explanation
for the trend.
The 3-year
project will involve examining frozen tissue samples from almost
600 women diagnosed with breast cancer between 1980 and 1993.
The researchers,
from the Edinburgh Breast Unit Research Group, will study the
frozen samples for hormone levels, carcinogens and agents known
to cause genetic damage. They hope to establish whether women
from socially deprived backgrounds have higher levels of these
damaging agents in their cancerous tissue.
It is hoped
that if the study can identify factors associated with social
class that influence the outcome of the disease, it may be possible
to take preventive action.
In a statement
announcing the study, lead researcher Professor William Miller
said, ''It has been known and accepted for some time that women
from more affluent backgrounds are more at risk of developing
this disease. However, less well documented is the 'reverse phenomenon,'
where, once diagnosed, more affluent women do better than the
socially deprived.''
He added,
``An important factor influencing outcome is the extent of tumour
spread, but even women who apparently have the same extent of
disease may survive for different lengths of time. Other factors
are clearly involved, including social background; women coming
from deprived areas do less well than those who are more affluent.''
Around 38,000
new cases of breast cancer are diagnosed in the UK every year.
Lifestyle risk factors are thought to include having children
late in life or not having children at all, as well as hormone
replacement therapy and, possibly, long-term use of oral contraception.
The Cancer
Research Campaign (CRC) says affluent women are thought to be
more at risk of breast cancer because they delay childbirth and
have fewer children than lower-income women do. Pregnancy offers
a respite from high oestrogen levels--thought to be a risk factor
for the disease--so early and frequent childbirth may help to
protect against it.
Spokeswoman
for the charity, Sara Hiom, told Reuters Health, ''The more oestrogen
exposure, the more risk of breast cancer.''
But several
factors may explain the so-called ``reverse phenomenon,'' according
to the CRC. It could be that cancers are diagnosed at an earlier
stage among more affluent women, due to better relationships with
doctors and screening programmes, or that they more likely to
be generally healthy and better equipped to cope with cancer treatments.
It may even
be that affluent women are more likely to have supportive backgrounds,
be better informed and feel more relaxed and in control, the CRC
said.
``We shall
await the results of this study with great interest, especially
as it is comparing a large number of women all being treated under
similar conditions at the same centre,'' Hiom said. ``Hopefully,
it will tell us what the factors are causing these real and worrying
differences between survival in the different groups of women.''
Reference
Source 89
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