Experts predict 3 million new cases a year of breast cancer worldwide by 2040 and a million deaths, with people living in low- and middle-income countries disproportionately affected.

Despite major advances in the diagnosis and treatment, inequalities mean that many women worldwide still experience significant suffering related to physical symptoms, emotional despair, and financial burden.

These are among the conclusions of the new Lancet Commission, led by Professor Charlotte Coles from the University of Cambridge, which sets out recommendations to tackle these urgent challenges in breast cancer. The Commission builds on previous evidence, presents new data, and integrates patient voices to shed light on a large unseen burden.

“Recent improvements in breast cancer survival represent a great success of modern medicine. However, we can’t ignore how many patients are being systematically left behind.”
Professor Charlotte Coles, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust

Professor Coles added: “We hope that, by highlighting these inequities and hidden costs and suffering in breast cancer, they can be better recognised and addressed by health care professionals and policymakers in partnership with patients and the public around the world.”

At the end of 2020, 7.8 million women were alive having been diagnosed with breast cancer in the previous five years. Progress in research and cancer management has led to a decrease of over 40% in breast cancer mortality in most high-income countries. Estimates suggest that global breast cancer incidence will rise from 2.3 million new cases in 2020 to over 3 million by 2040.

Although breast cancer is the most common cancer, gaps in knowledge continue to prevent effective action.

Building on previous work, the Commission report also discusses serious health-related suffering, an indicator of the need for palliative care, with estimates provided by a small expert group. In 2020, an estimated 120 million days were spent with serious health-related suffering per year for people who died of their cancer. A further 520 million days were estimated for patients living with the disease. Behind these numbers are individuals experiencing pain, shortness of breath, fatigue, and other, often resolvable, distressing symptoms.


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