Malignant Rumor by David Gratzer
A number is not automatically a statistic, especially when it's a rough calculation based on 7-year old OECD data.
Dr. David Gratzer, a physician and senior fellow at the Manhattan Institute, has come under fire for his estimation of prostate cancer survival rates in the UK as compared to the US which was picked up by the Rudy Giuliani campaign for a radio spot endorsing his plan to revamp health care. In the spot, Rudy says,
"I had prostate cancer five, six years ago. My chance of survival prostate cancer--and thank God I was cured of it--in the United States: 82%. My chances of surviving prostate cancer in England: only 44% under socialized medicine." Actually, his chance of survival depends upon the grade of his particular prostate cancer. The way this is worded, it metaphorically paints Rudy as representing the average case of prostate cancer.
These numbers were picked up from an article by Gratzer in his "The Ugly Truth About Canadian Health Care" City Journal piece from this past summer.
Politics aside, this latest article published on the City Journal Web site shows that this was a quick and dirty calculation of survival based on prevalence and mortality data. Therefore, it should be identified as such and should not be confused with a formal study of survival.
According to OECD data published in 2000, 49 Britons per 100,000 were diagnosed with prostate cancer, and 28 per 100,000 died of it. This means that 57 percent of Britons diagnosed with prostate cancer died of it; and, consequently, that just 43 percent survived.
This "snapshot" way of looking at survival, as Gratzer calls it, shouldn't be touted as a statistical representation of survival especially when better data exist. And the folks who write ad copy for a presidential candidate should realize that any mathematical machination will be fact checked almost immediately.
Intuitively, I can believe that the US might have better screening programs, provide more access to chemotherapeutic agents, but this needs to be borne out by reliable study.
Gratzer cites the journal Lancet Oncology in saying that the current study of 5-year survival for prostate cancer in America is 99%, while the European average is 78%. British data were incomplete.
This is not meant to be an indictment of the free market approach to health care. Gratzer's most recent book, published just over a year ago, is "The Cure: How Capitalism Can Save American Health Care." It just goes to show though.
UPDATE: I believe this is the citation for the 78% number:
Lancet Oncol. 2007 Sep;8(9):784-96.
Recent cancer survival in Europe: a 2000-02 period analysis of EUROCARE-4 data.
Verdecchia A, Francisci S, Brenner H, Gatta G, Micheli A, Mangone L, Kunkler I; EUROCARE-4 Working Group.
From its abstract:
The European mean age-adjusted 5-year survival calculated by the period method for 2000-02 was high for testicular cancer (97.3% [95% CI 96.4-98.2]), melanoma (86.1% [84.3-88.0]), thyroid cancer (83.2% [80.9-85.6]), Hodgkin's disease (81.4% [78.9-84.1]), female breast cancer (79.0% [78.1-80.0]), corpus uteri (78.0% [76.2-79.9]), and prostate cancer (77.5% [76.5-78.6]);...
This is also the citation used by Betsy McCaughey at the National Center for Policy Analysis who Gratzer is quoting in his blog post.