Five year survival rate and cancer


FAULTY COMPARISONS USING FIVE-YEAR SURVIVAL

Because five-year survival is affected by the timing of diagnosis and who is diagnosed, it is an unreliable statistic for drawing conclusions about the quality of medical care across time. But that doesn't stop people from making faulty comparisons based on five-year survival and promoting those comparisons as evidence of the value of cancer research and early detection.

In 1999, for example, former Vice President Gore, arguing against Republican tax cuts that would have resulted in a smaller budget for the National Institutes of Health, announced that five-year survival rates for all cancers had risen to almost 60% in early 1990s, up from 51 % in the early 1980s. In reality, however, the mortality rate for all cancers combined increased over that period (although they have gone down since then)

. Similarly, in 1998 Senator Kay Bailey Hutchinson (R-Tex.) made the case for breast cancer screening on the ground of the U.S. Senate: "When detected early and when confined to the breast, the 5-year survival rate for this disease is over 95%. Mr. President, this is a remarkable statistic, and represents a dramatically improved picture than [sic[]|] that of even not too long ago."7 Yet as the next article shows, there is considerable debate about whether mammography really does work.

Faulty comparisons are also made between countries. The Office of National Statistics in the united kingdom noted that five-year survival for colon cancer was 60% in the usa compared to 35% in Britain. British experts reacted to the finding as "disgraceful," and many called for a doubling of government spending on cancer treatment.

In response, Prime Minister Tony Blair vowed to increase survival rates by 20% over the next 10 years, decrying the truth that "we don't match other countries in its [colon cancer's[]|] prevention, diagnosis and treatment."8 In fact, despite the gap in five-year survival rate statistics, the mortality rate for colon cancer in England is only slightly higher than that in the united states.

The comparison is even more faulty for prostate cancer. In early 1990s, the prostate cancer five-year survival rate was a little over 40% in the united kingdom, versus over 90% in the usa. While it may be tempting to conclude that our medical care system is vastly superior, the U.S. mortality rate at the time was actually slightly higher than the British rate. Our prostate cancer five-year survival is so much higher only because we tell books people they have prostate cancer.

I don't want to be misunderstood, so let me be very clear about what I am not saying and what I am saying.

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This article was sent to us by: Fiona Landman at 08152010

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