Opinion
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Lies, Damned Lies, and, Well, You Know: The New York Times is parsing Rudy Guiliani's prostate cancer statitistics:
"I had prostate cancer five, six years ago," Mr. Giuliani, a Republican presidential candidate, said in a speech that has been turned into the radio commercial. "My chance of surviving prostate cancer β and, thank God, I was cured of it β in the United States? Eighty-two percent. My chance of surviving prostate cancer in England? Only 44 percent under socialized medicine."
.... The Office for National Statistics in Britain says the five-year survival rate from prostate cancer there is 74.4 percent. And doctors also say it is unfair to compare prostate cancer statistics in Britain with those in the United States because in the United States the cancer is more likely to be diagnosed in its early stages.
"Certainly, if you intensively screen for prostate cancer, you will find early disease,β said Dr. Ian M. Thompson, chairman of the department of urology at the University of Texas at San Antonio. "And simply because you find it earlier, you will always have longer survival after the disease is diagnosed."
One reason that prostate cancer is diagnosed earlier in the United States than in Britain is that they don't screen for it at all in Britain - at least not at the expense of the NHS. (Which is one of the reasons they spend less on healthcare than the United States. They don't indulge in as much screening as we do.) At any rate, his statistics don't appear to be all that far off the mark, at least for men in their 80's. But even the NHS admits that prostate cancer survival is increasing because more people are starting to have their PSA checked - meaning that slow growing early cancers are being added to the mix, just as happens here in the US. As it happens, even back in 2002, the five year survival rate for prostate cancer in the US was 99% - still a much better figure than the UK's 71%.
But, as the astute bloggers point out, prostate cancer isn't the best example of the benefits of screening. Prostate cancer is, in most cases, slow growing - and although our screening policies detect many early cancers that would never do harm if left undetected, we also end up spending a lot more money treating these same cancers. When given the choice between watchful waiting and removal, many choose removal. (Another reason why we end up spending more and being less healthy in surveys like this.)
But the Astutes take a closer look at cancer in England and cancer in the US:
See this report, entitled "Cancer Survival Rates Improving Across Europe, But Still Lagging Behind United States" (and remember that England's rates, not broken out, are among the worst in Europe).
Taking recent figures, female five-year cancer survival rates are 62.9 per cent on average in the US and 52.7 per cent in England. To compare America's privately insured with England's NHS patients, you'd need to bump up that American survival rate a bit (the uninsured most likely have lower survival rates--otherwise why worry about universal coverage) and bump down the English one (because some Brits have private insurance, and so buy better care).
Nationally, American cancer survival rates are significantly better. Certainly not by the 40-point margin Giuliani implied, but still.
Looks like the truth is somewhere between Rudy and the Times.
Author : noreply@blogger.com (sydney)
Publ.Date : Fri, 02 Nov 2007 01:43:00 +0000
Spooky Skulls:Spooky brain pictures. Background here.
Author : noreply@blogger.com (sydney)
Publ.Date : Mon, 29 Oct 2007 01:58:00 +0000
Errors, Errors: The sad story of a medical error and learning to deal with errors.
Author : noreply@blogger.com (sydney)
Publ.Date : Mon, 29 Oct 2007 01:35:00 +0000
I Screen, You Screen: The American Academy of Pediatrics is recommending that all children be screened for autism. They've only press-released their recommendations, however, so it's difficult to assess them. Wouldn't it be nice if professional organizations actually released their recommendations to their members before they did so to the public? It would make it so much easier for doctors to discuss the news stories with their patients. They're releasing them today at their annual conference, and later in the November issue of their journal, which is not yet available online. (Though it may be in AAP member's mailboxes.)
Part of any well child visit is screening for developmental delays, so one has to wonder what's different about these recommendations. Are they setting lower limits for what's abnormal so that those mild cases of autism (which some argue aren't really autism or even disease) can be treated? If that's the case, then don't be surprised when a couple of years from now there's a upward spike in the number of cases of autism. And don't blame it on vaccines.
Author : noreply@blogger.com (sydney)
Publ.Date : Mon, 29 Oct 2007 11:56:00 +0000
All Saints' Day: A list of medical saints - albeit an incomplete one.
Author : noreply@blogger.com (sydney)
Publ.Date : Fri, 02 Nov 2007 01:57:00 +0000
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News and Articles
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Opinion
Heroic Measures Extend Life of Surgical Pioneer and Stir Debate
One year later, the story of Dr. Michael Debakey getting an operation he pioneered at age 97. -from medpageToday.
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Jan 8, 2007, 16:16
News and Articles
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Opinion
Post-election Symposium on Health Care
After gaining control of Congress, Democrats have vowed to make health care a priority for the next two years. Experts weigh in on this topic. -from Medical Progress Today.
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Jan 3, 2007, 12:33
News and Articles
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Opinion
Best Blogs: 10 Health Web Sites Worth a Click
A growing number of bloggers are focusing on the
topic of health. Doctors and nurses and ambulance drivers are blogging
about their on-the-job experiences. Patients are blogging about their
struggle with a particular disease or condition, sharing their stories
with friends, family and others with similar issues. -from Fox news (health).
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Dec 4, 2006, 19:40
News and Articles
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Opinion
Comparison Shopping for Healthcare
Its no secret that people are turning to the Internet for healthcare
advice, bypassing even their trusted doctors to access information.
Some people think this is a good thing....
Others, especially the doctors, are dismayed that people are getting
false or misleading information from Web sites. -from The Healthcare IT Guy.
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Nov 25, 2006, 09:43
News and Articles
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Opinion
When Young Doctors Strut Too Much of Their Stuff
When I was a new faculty physician, I worked with a resident doctor who
was smart and energetic and took excellent care of her patients. There was just one problem. As she delivered her thoughtful patient
presentations to me and the other attending doctors, it was hard not to
notice her low-cut dress. - from The New York Times.
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Nov 22, 2006, 20:04
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Friday, November 21
