Download Cancer in midlife and beyond

Cancer in midlife and beyond - background information
Key messages

Cancer is a major cause of death in women throughout the world

Women should regularly consult their doctor for a general check-up – this is especially
true at the time of the menopause

A healthier lifestyle will help lower cancer risks
What is the problem?
Cancer is a major cause of death in women. Cancer incidence is increasing, partly due to the fact that more
women live longer. Many cancers can be prevented, if women make the correct health and lifestyle
decisions earlier in life.
Cancer is not a single disease, and the chances of contracting or surviving cancer can vary dramatically
according to which cancer a woman has. In general, it is worth noting that, with adequate treatment,
survival rates for cancer are generally improving.
It is extremely important to consult one's doctor as soon as abnormal symptoms occur as this could help to
achieve a better prognosis by providing an early diagnosis, especially in the case of cancer. There are many
misconceptions about cancer, and accurate information about risk factors, incidence and mortality is
important in improving women's knowledge and helping them to achieve healthy aging.
Why is the menopause specifically important?
More cancers occur with increasing age, meaning that most cancers occur after the menopause. The
menopause is an important milestone for women, and so it can be an opportunity for women to reassess
their health, and to make changes which will help towards living a healthier, cancer-free life.
In addition, the menopause itself either causes, or is associated with, major changes to a women’s body.
Some of these changes may affect the likelihood of some cancers – some risks will increase, some decrease.
So it is important that women and their doctors should be aware of the possible health outcomes
associated with the menopause.
The scale of the problem - let’s put it in context
Cancers accounted for 8 million deaths world-wide in 2010, representing 15.1% of all deaths world-wide for
both sexes.
Lee Tomkins, IMS Executive Director, PO Box 98, Camborne TR14 4BQ, UK
Tel: +44 1209 711054, Fax: +44 1209 610530, E-mail: [email protected]
Among women, 20–25% die from cancers in Western Europe, Australasia, high-income North America,
high-income Asia Pacific, East Asia and Southern Latin America. In comparison, Cardio/circulatory diseases
represent 35–40% of causes of death in most developed countries, 32–48% in Latin America and the
Caribbean, peaking at 70% in Eastern Europe, 60% in Central Europe and Central Asia, and 45% in North
Africa and the Middle East. In Sub-Saharan Africa and Oceania, less than 20% of women will die from
cardio/circulatory diseases. The main cause of death in Southern Sub-Saharan Africa is HIV.
Many women fear cancer more than any other disease, but in fact, cardiovascular disease kills more
women than cancer does.
Some facts on cancers
Breast, lung and cervical cancers are the most common in women, followed by colorectal cancer. Mortality
from breast cancer represents 13.7% of worldwide mortality from cancer in women, followed by lung
cancer at 12.8%, colorectal cancer at 8.6% and cervical cancer at 8.2%. Mortality from ovarian cancer
(4.2%) and uterine corpus (endometrial) cancer (2.2%) is much less.
Breast cancer: in the West, this is mostly a postmenopausal disease, whereas in some areas, e.g. India,
Pakistan, North Africa, it occurs predominantly in younger women. Breast cancer is about as common in
developed countries as it is in developing countries.
Lung cancer: in some countries, lung cancer is the leading cause of cancer mortality, such as in the USA,
Canada, Hong Kong, China, UK, Denmark, Norway, Sweden and Korea
Cervical Cancer: The world incidence of cervical cancer has increased by 0.6%/year in the past 30 years,
with more than 85% of the global burden occurring in developing countries. Deaths from cervical cancer
are closely associated with lack of access to good–quality health care.
For more information, see Gompel A, Baber RJ, de Villiers TJ, et al. Oncology in midlife and beyond.
Climacteric 2013;16:522-35
Access to health care
Increased mortality is usually associated with low access to the health-care system and low socioeconomic
development.
In any single country, the differences in genetics, access to health care, and socioeconomic disparities can
lead to differences in the mortality rate for a given cancer. For example, in the USA African-American
International Menopause Society, October 2013
women have a 7% lower incidence rate of cancers compared to White women, while their overall cancerrelated death rate is 17% higher9.
It is important that women going through the menopause make appropriate use of the heath-care system
which is available to them.
When should women consult a doctor?
Women and their doctors should plan a systematic follow-up at least once a year, for each woman in
midlife and beyond. In addition, if a woman experiences any abnormal symptoms, she should see her
doctor immediately. These symptoms may include:

Abnormal vaginal bleeding, pelvic/abdominal pain

Unusual digestive symptoms, blood in the feces, urine

Breast abnormalities

Unusual cough

VTE (a blood clot in a vein) in women with no family history.
Pharmaceuticals and cancer
Some drugs need to be treated with caution if women have an increased risk of cancer (for example, if a
woman has a family history of breast cancer). Some types of Hormone Replacement therapy (HRT) for
example, are associated with a slightly increased risk of breast cancer; some types of HRT slightly reduce
the risk of breast cancer. Women should discuss their individual risk factors with their doctor before
embarking on any course of treatment.
The best way to avoid an increased risk of cancer is to lead a healthy lifestyle, and to avoid contact with
possible cancer-causing chemicals.
Tips for a healthy menopause
1. Maintain a regular exercise routine.
2. Restrain intake of caffeine, sugar, salt and alcohol.
3. Do not smoke.
4. Eat foods containing adequate amounts of calcium and vitamin D.
International Menopause Society, October 2013
5. Maintain a regular and sufficient sleep schedule.
6. Maintain a low-fat, well-balanced diet.
7. Take hormone therapy if needed.
8. Proactively manage menopause and use it as an opportunity to prevent disease and improve long-term
health and quality of life.
More information is available on the IMS website, http://www.imsociety.org/
International Menopause Society, October 2013