October is Breast Cancer Awareness Month. Breast cancer remains the most common type of invasive cancer in women in Ireland. Approximately 3,700 cases are diagnosed here each year (including about 30 in men), a figure that has been predicted to rise to almost 5,000 annually by 2045. At least 1 in 10 women will be diagnosed with breast cancer in their lifetime.
Unfortunately, cancers of all types continue to place a significant burden on individuals and families and on the broader health system. One in two of us will develop a cancer during our lifetime and cancer accounts for about one third of all deaths annually in Ireland. In younger people under 65, cancer causes half of all deaths in women and over one-third of all deaths in men.
And yet, despite this burden, it’s worth reflecting on the many significant advances that have been made in preventing, diagnosing and treating cancer in Ireland over the past 20 years.
- Most cancers show static or declining trends in both incidence and mortality rates
- Mortality rates are falling for the four ‘major’ cancers – breast, prostate, lung and bowel; mortality from breast cancer has decreased by about 2% per year since the late 1990s
- More people are now surviving their cancer than ever before, with 5-year survival now averaging 65% (88% for breast cancer), compared with just 42% in the 1990s, and there are an estimated 200,000 people currently living with or beyond cancer in Ireland.
These advances have not happened by chance. The establishment of the National Cancer Control Programme in 2007 was pivotal, as has been the establishment of centres of excellence, the widespread buy-in to multidisciplinary team working, the establishment of rapid access clinics for early diagnosis, the implementation of national screening programmes for breast, cervical and bowel cancer, and advances in diagnostics, surgical intervention, radiation and systemic therapies.
In addition, there has been a remarkable effort to establish world-leading translational research programmes to investigate and support improved outcomes for patients; academic research output on breast cancer, for example, has increased almost tenfold over the past 20 years.
And, allied to all of this work, has been a sustained effort by policymakers over two decades to address modifiable lifestyle factors which increase the risk of cancer, including alcohol and smoking and, more recently, avoidance of overweight and obesity and promotion of physical activity.
It is vital that these efforts are sustained and built upon. While the cancer incidence rate (the number of cancers diagnosed per 100,000 population) had declined steadily for most cancers, increases in population size and ageing have meant that the actual number of cancers diagnosed in Ireland continues to increase year on year. Unfortunately, that trend is expected to continue; in 2019, the National Cancer Registry suggested that the numbers of invasive cancers here could rise to approximately 43,000 cases annually by 2045 - a doubling of numbers overall; and that was before the most recent census figures were published which suggested that the population is now growing even faster than had been previously anticipated.
In the context of these rising numbers then, two priority areas of focus will need to continue to be prevention and early detection and, it is in this context, that Breast Cancer Awareness Month (BCAM) is so important. The initiative has gradually grown from a week-long event which started in the United States in 1985 and was promoted by Betty Ford who had herself been diagnosed with breast cancer while First Lady in the 1970s. Today it is a global health campaign which aims to increase awareness of the disease and to raise funds for research into its causes, prevention, diagnosis, treatment and cure.
From your perspective, during Breast Cancer Awareness Month, you can take the opportunity to
- Be breast aware – check your breasts and know what is normal for you so that if any unusual change occurs, you will recognise it.
- Reduce your risk
- Be active: Try to do at least 30 minutes of moderate physical activity on 5 or more days a week.
- Limit alcohol: Alcohol is responsible for about 1 in 8 breast cancers in Ireland. The more you cut down on alcohol, the more you can reduce your risk of breast cancer.
- Don’t smoke: Smoking causes at least 15 different types of cancer and it has been linked to a higher risk of breast cancer in younger, premenopausal women
- Breastfeed your baby: Breastfeeding helps to protect mothers from breast cancer. The longer a woman breastfeeds her baby, the more she reduces her breast cancer risk.
- Ensure you are up to date with screening. Breast screening is used to help find breast cancer when it is too small to see or feel. When breast cancer is found early, it is easier to treat and there is a better chance of recovery. In Ireland, all women between the ages of 50 and 69 years are invited to take a mammogram every 2 years through the BreastCheck Screening Programme. More information is available here.
- Get involved! Many organisations will be looking for people to volunteer, to organise an event or to donate in support of Breast Cancer Awareness Month. More information on some of these organisations is available at the following links
