Great News on Breast Cancer Is Hidden by Alarmist Reporting

Breast cancer mortality is way down, but coverage emphasizes incidence.

Reviewed by Gary Drevitch

Key points

• Our fears of cancer are in some ways out of date. It is no longer always fatal.
• Despite great progress, news reports about cancer are almost always alarming and tragic.
• Fear of cancer can lead to choices that do more harm than the disease itself.

It’s Breast Cancer Awareness Month, and a new report from the American Cancer Society features good news and bad. Predictably, the bad news is getting way more attention. But that’s how it’s been with cancer since increasing life spans at the beginning of the 1900s made it the second-leading cause of death in the U.S. and, because there was no cure, the most feared. The frightening and tragic aspects of this cruel disease are most of what we hear. The phenomenal progress that has been made gets less attention—for example, that as many as two-thirds of cancers are now treatable as chronic diseases or curable outright.

There is a harmful, hidden consequence to this negativity. It perpetuates an outdated fear of an inevitably fatal disease, seared into public belief decades ago, that no longer matches the evidence, and does great harm all by itself. What some have called cancerphobia injures tens of thousands annually, kills hundreds, and wastes billions of dollars in health care spending. As we battle the disease itself we must also wage war on cancerphobia in order to reduce its harms. Part of that war must be about changing the disproportionately alarmist way the disease is portrayed to the public by the commercial media, by social media, and by the cancer advocacy community itself.

Here’s the good news, from a fresh report from the American Cancer Society: Breast cancer mortality—people dying from the disease—is down 44% since 1989. Five-year survival rates for invasive (potentially life-threatening) breast cancer have risen from 77% for White women and 65% for Black women in 1975-77 to 93% and 84% in 2014-2020. That incredible progress has saved an estimated 517,900 lives. The bad news is that breast cancer incidence—people diagnosed—is increasing by 1% per year; 1.4% for women under 50. That's bad news for sure. But remember: Fewer people who get breast cancer now die from it. So the bad news about incidence is significantly offset by the reassuring evidence that breast cancer has become far more treatable.

But that’s not the big picture the public is getting about these new figures. This is the first line from USA Today‘s story about the ACS report; “Over the past decade, breast cancer rates have risen by 1% a year, with the steepest increase occurring in women younger than 50.”

The headline in the New York Times, "Breast Cancer Continues to Rise Among Younger Women, Study Finds," was followed by this lead paragraph: “Rates of breast cancer—the second-leading cause of cancer deaths in U.S. women—climbed by 1 percent a year from 2012 to 2021, and even more sharply among women under age 50 and among Asian American/Pacific Islander women of all ages.”

The ABC News program Good Morning America, hosted by breast cancer survivor Robin Roberts, posted an online story which gives precedence to the good news in its first paragraph: “Breast cancer deaths have fallen by 44% compared to 35 years ago, saving nearly 520,000 lives, according to a new report by the American Cancer Society.” But an online video piece from ABC News, in which an expert is interviewed, quickly pivots to and spends most of its discussion dwelling on the bad news; “The good news here obviously that mortality rates are down 44% compared to 35 years ago, a pretty significant drop there. But I want to ask about this increase in diagnoses in younger women…"

The news media are hardly alone; the American Cancer Society press release itself leads with reassuring news about progress, but pivots to and focuses more on the bad: “The new report finds breast cancer mortality rates overall have dropped by 44% since 1989, averting approximately 517,900 breast cancer deaths. However, not all women have benefited from this progress, notably American Indian and Alaska Native (AIAN) women, whose rates have remained unchanged over the past three decades. Also concerning is the continued upward trend in breast cancer incidence, rising by 1% annually during 2012-2021, with the steepest increase in women younger than 50 years (1.4% per year) and Asian American/Pacific Islander (AAPI) women of any age (2.5%-2.7% per year)."

Here's how the ACS posted on X: “New findings from @AmericanCancer today show that #BreastCancer rates continue to rise at a faster pace in women younger than 50 years compared to those 50 or older.” Other social-mdia accounts are rife with posts like this one, which states right up front that it’s about scaring the reader:

The reassuring ACS chart showing mortality reduction (below), which depicts the bigger—but positive—picture, is hard to find to find in this coverage.

There are profound impacts from this drumbeat of negative news. Fear of cancer, which many still believe is always fatal, is in part why, according to the CDC, roughly 35 million people outside the ages for which cancer screening was recommended screened anyway in 2018. That overscreening cost the U.S. health care system an estimated $37 billion. Fear of cancer is why tens of thousands of people diagnosed each year with breast, prostate, thyroid and lung cancers that are slow or non-growing, that haven’t spread and are unlikely to cause any harm, choose more aggressive treatment than their clinical conditions require. These are “fear-ectomies” that leave tens of thousands with serious lifelong side effects; a small number of them have even died from them.

The pain and suffering of cancer has touched many of our lives. But a fear imprinted in us decades ago, when a diagnosis of cancer was a death sentence, is now in some ways out of date. That fear, fostered by the imbalanced and alarmist attention cancer gets from commercial and social media and from much of the cancer community, perpetuates a cancerphobia that we need to heal every bit as much as we need to fight the disease itself.