If GOP Presidential candidate Rudy Giuliani had been a British resident, he may well have died of prostate cancer. At least that’s what he claims.
He’s wrong.
Rudy Giuliani survived a bout with prostate cancer several years ago, and now notes that his chances of survival were much higher in the US than if he were in England. Quoting from a discredited story authored by the Manhattan Institute’s David Gratzer, Rudy has been claiming the prostate cancer survival rate in the UK is 44%, about half that enjoyed by Americans (82%).
Actually, he’s wrong on both stats – the survival rate in the UK is 78% while it is even higher here in the US at 99%. But, the methodology and data used to determine those rates are not directly comparable, and therefore the results aren’t either.
Gratzer pulled data from a Commonwealth Fund study published in 2000, data that does not support Giuliani’s statement, and was actually misused by Gratzer in his original piece.
But Gratzer refuses to admit defeat. In his latest rationalization, the good doctor (Gratzer is an MD) tries to explain Rudy’s misstep. Here’s what Gratzer says:
“the percentage of all Americans who die from prostate cancer is similar to the percentage of all Britons who do. But this misses the point, since a much higher percentage of Americans than Britons are diagnosed with prostate cancer in the first place.”
What the doc may not remember from medical school is that prostate cancer is quite common among older men. It usually grows very slowly, so slowly that most of us end up dying from something else. Gratzer is correct when he says that more Americans than Britons are diagnosed with prostate cancer, but most of the diagnoses are likely of these very slow growing cancers that are unlikely to be fatal.
What the diagnoses do, rather effectively, is scare the bejesus out of patients, and encourage them to get procedures that are not only costly and of uncertain benefit, but also may render the patient impotent, incontinent, or dead. Since the Brits don’t do as much screening for prostate cancer, they don’t do a lot of operations on patients that may not need them.
Looking at more recent data, and employing Rudy’s logic (better survival rates = better health care systems), we find that the 5 year survival rate for kidney transplant patients was 94% in Canada, 86% in the UK, and 83% in the US in 2001.
I guess Rudy better move to Canada if his kidneys start misbehaving,
Joe:
I think you are doing the same thing with kidney transplant statistics that you accuse Rudy of doing with prostate cancer statistics.
How many Kidney transplants are done in the UK and Canada? Are the acceptance for transplant criteria the same? Is the survival rate measured the same way (death from other causes etc.)
Charles – no, I’m not. The stats I referenced were derived from the same analysis by the Commonwealth Fund, using the same methodology.
I suggest you click thru to the urls and read the underlying document. That’s why I include them.
Joe
Oh, Mr. Paduda, I think you walked into this one….
If you go to Canada’s National Organ Tissue & Donation Site, you’ll read that “Canada’s organ donation rate ranks in the bottom half of countries in the western world where transplants are performed. More than 3,500 Canadians are waiting for an organ transplant, and every year nearly 150 of them die, waiting.”
According to the wikipedia entry on “kidney transplantation” Canada had 1,112 kidney transplants in 2000 (population 31 million) and the U.S. 15,137 in 2003 (population 291 million). So, Canada’s population was 11% of the U.S. but only had 7% of the number of transplants.
It looks to me like the reason the 5-year survivability is better is because more Canadians died before they had a chance to get transplants.
Mr. Graham – thanks for the comment. I’m not sure what to make of your assumption. I suppose it is possible that you are more likely to die waiting for a kidney (altho the data are not organ-specific) in Canada than in the US. It could also be that post-op care is better up north, and/or they do a better job screening organs & patients, and/or any of a number of other factors.
What the data do indicate is outcomes are better in Canada.
And Rudy is a liar.