Stat Wars: Giuliani and the Prostate Cancer Debate

A lot of donkeys are braying about Rudy Giuliani’s radio ad in which he has the audacity to applaud the American health care system. Specifically, they’re creating a din about Hizzoner’s comparison of U.S. and British survival rates relating to prostate cancer:

My chance of surviving prostate cancer — and, thank God, I was cured of it — in the United States? Eighty-two percent. My chance of surviving prostate cancer in England? Only 44 percent under socialized medicine.

So, is “America’s Mayor” fudging the numbers? Are American and English cancer survival rates about the same? Not according to David Gratzer and Clive Crook. Here’s how the former puts it:

The percentage of people diagnosed with prostate cancer who die from it is much higher in Britain than in the United States … 57 percent of Britons diagnosed with prostate cancer died of it; and, consequently, just 43 percent survived.

And here’s how the latter brings the point home:

Nationally, American cancer survival rates are significantly better … And here is the politically salient question: If you have cancer, would you rather be an American with insurance or an Englishman without? The answer is obvious.

Indeed it is. Giuliani’s political ad, like all examples of the genre, makes considerable use of hyperbole. But no matter how much racket the jackasses make, his basic point is irrefutable.

[HT RCP]

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Comments 5

  1. drmatt wrote:

    Gratzer and Crook!? You get your health care statistics from journalists! Maybe you should get your health care advice from them as well. These are people who are trained to pull out awe inspiring lines from studies, not to assess the study, construct, and value. Another example of poorly researched rhetoric to make a point. If you end up in one of those ERs that you mentioned earlier you should call the journalist and ask what to do.

    Posted 01 Nov 2007 at 2:18 pm
  2. Catron wrote:

    Gratzer is a physician. His bio can be read here.

    Posted 01 Nov 2007 at 2:36 pm
  3. Marc Brown wrote:

    Giuliani’s claim is nonsense, David. This is 101 stuff - many prostate cancers are very slow growing and don’t kill men, so their diagnosis is not related to mortality. Five year survival rates therefore are meaningless. This is also why the hoped for effect of breast screening has turned out to be marginal. And what’s more, many Americans never get counted because they don’t get treated properly. If you were to count all Americans with cancer, you would undoubtedly be below the Western European average.

    Posted 01 Nov 2007 at 2:48 pm
  4. drmatt wrote:

    Sorry, he has an MD, but based on what i have read about him he is not a physician, he is a journalist.

    In an interview, Dr. Gratzer said the statistic came from the Commonwealth Fund, a nonprofit group in New York specializing in health care policy issues, but he acknowledged that it was seven years old and “crude.”

    But the Commonwealth Fund said yesterday that Dr. Gratzer had misused its research by calculating a five-year survival rate based on data on prostate cancer incidence and mortality rates in the United States and Britain.

    Anybody who contorts data to make headlines (Study stats for a while you will see that you cant “calculate” survival rates, they have to actually be measured.) is a journalist, god he admits to using crude data, don’t you get it? But go ahead, take medical advice from him, good luck.

    Posted 01 Nov 2007 at 3:03 pm
  5. spike wrote:

    You’re leaving out the fact that far more Americans are diagnosed with prostate cancer than Britons, kind of important information. The only Brits that get diagnosed with prostate cancer are those with serious symptoms more likely to be fatal. We diagnose every case thanks to our aggressive screening procedures. The overall mortality rates from prostate cancer are virtually identical in the two countries. So yes, Rudy is making an irrelevant point by simply pointing out cure rates among those diagnosed with the cancer.

    Posted 01 Nov 2007 at 10:24 pm

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