Cancer survival and health care reform:
Selective statistics paint distorted picture
By Barbara O’Brien / The Rag Blog / January 7, 2010
One argument you may hear against health care reform concerns cancer survival rates. The United States has higher cancer survivor rates than countries with national health care systems, we’re told. Doesn’t this mean we should keep what we’ve got and not change it?
Certainly cancer survival rates are a critical issue for people suffering from the deadly lung mesothelioma cancer. So let’s look at this claim and see if there is any substance to it.
First, it’s important to understand that “cancer survival rate” doesn’t mean the rate of people who are cured of a cancer. The cancer survival rate is the percentage of people who survive a certain type of cancer for a specific amount of time, usually five years after diagnosis.
For example, according to the Mayo Clinic, the survivor rate of prostate cancer in the United States is 98 percent. This means that 98 percent of men diagnosed with prostate cancer are still alive five years later. However, this statistic does not tell us whether the men who have survived for five years still have cancer or what number of them may die from it eventually.
Misunderstanding of the term “survivor rate” sometimes is exploited to make misleading claims. For example, in 2007 a pharmaceutical company promoting a drug used to treat colon cancer released statistics showing superior survival rates for its drug over other treatments.
Some journalists who used this data in their reporting assumed it meant that the people who survived were cured of cancer, and they wrote that the drug “saved lives.” The drug did extend the lives of of patients, on average by a few months. However, the mortality rate for people who used this drug — meaning the rate of patients who died of the disease — was not improved.
But bloggers and editorial writers who oppose health care reform seized these stories about “saving lives,” noting that this wondrous drug was available in the United States for at least a year before it was in use in Great Britain. Further, Britain has lower cancer survival rates than the U.S. This proved, they said, the superiority of U.S. health care over “socialist” countries.
This is one way propagandists use data to argue that health care in the United States is superior to countries with government-funded health care systems. They selectively compare the most favorable data from the United States with data from the nations least successful at treating cancer. A favorite “comparison” country is Great Britain, whose underfunded National Health Service is struggling.
It is true that the United States compares very well in the area of cancer survival rates, but other countries with national health care systems have similar results.
For example, in 2008 the British medical journal Lancet Oncology published a widely hailed study comparing cancer survival rates in 31 countries. Called the CONCORD study, the researchers found that the United States has the highest survival rates for breast and prostate cancer.
However, Japan has the highest survival for colon and rectal cancers in men, and France has the highest survival for colon and rectal cancers in women. Canada and Australia also ranked relatively high for most cancers. The differences in the survival data for these “best” countries is very small, and is possibly caused by discrepancies in reporting of data and not the treatment result itself.
And it should be noted that Japan, France, Canada and Australia all have government-funded national health care systems. So, there is no reason to assume that changing the way health care is funded in the U.S. would reduce the quality of cancer care.
Before I left home to join the Navy my grandfather gave me several pieces of advice. One piece was: “Figures don’t lie but liars can figure.”
The matter of pure survival time for a cancer patient is not an enlightened way of facing the issue. Much more important is the time the individual has to llive a full, productive life while living with cancer. For instance one might live for 15 months with terrible, debilitating side effects of chemotherapy, or one might live for 10 months with very little disability doing little but having a martini or two a day, or puffing a bit of pot. Which one would one choose?The Hospice movement originated in the UK; hence, the individual and his physician may choose this rather than a protracted death.
another aspect is that we're supposed to forget the different rate of DIAGNOSIS. That skews the numbers immediately. In England prostate cancer would be quickly and easily detected, Colon cancer the same way. But in America, somebody who never sees a Primary Care physician, develops cancer and dies in a Gutter isn't counted. American coroners aren't going to "waste money"