The Will Rogers phenomenon in the staging of breast cancer - does it matter?

Cancer Epidemiol 2015; 39: 115-7


Tan GH, Bhoo-Pathy N, Taib NA, See MH, Jamaris S, Yip CH


INTRODUCTION: Changes in the American Joint Commission on Cancer staging for breast cancer occurred when the 5th Edition was updated to the 6th Edition. OBJECTIVE: To investigate how these changes affected stage and survival. METHODS: 3127 cases of breast cancer were restaged. RESULTS: Late stages increased from 27.7% to 38.1%. The five-year survival improved in Stage 2 (82.9-86.1%) and Stage 3 (50.6-59%). DISCUSSION: Stage shift leads to an erroneous impression that women are presenting with later stages and stage-specific survival is improving. CONCLUSION: Standardizing cancer staging is important when reporting stage and survival in different time periods.


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The Occupational Medicine Clinic is a referral clinic for occupational diseases and is open on every Friday in University Malaya Medical Centre.