GEOGRAPHICAL VARIATION IN THE STANDARDIZED YEARS OF POTENTIAL LIFE LOST RATIO (SYPLR) IN WOMEN DYING FROM MALIGNANCIES OF THE BREAST IN ENGLAND AND WALES

Geographical variation in the standardized years of potential life los t ratio (SYPLR) in women aged 20-74 dying from breast cancer has been mapped by local authority district in England and Wales and compared w ith the variation as described by the standardized mortality ratio (SM R). The geographical distribution of areas of low and high SMRs is sim ilar to that observed some 15 years earlier, showing an increase from north to south. In contrast, the pattern of SYPLRs shows a less obviou s trend. Years of life lost because of breast cancer mortality were pa rticularly high in eight of the 401 county districts (SYPLR 1.22-1.48) and particularly low in nine (0.60-0.86). Mapping SYPLRs for breast c ancer gives a different pattern from mapping SMRs, and one which is po ssibly more appropriate for targeting resources in circumstances in wh ich death at younger age will have major social consequences. Care is required in interpreting maps indicating high and low rates in the pre sence of multiple comparisons. However, the range of values observed i s suggestive of the need to investigate districts with contrasting val ues of SYPLR with respect to the inter-relationships between sociodemo graphic characteristics, duration of symptoms, clinical presentation a nd treatment efficacy.