Saturday, July 25, 2009

The Prostate Cancer Lie

One of the fun things about lying with statistics is just how easy it is, if you pick the right statistics. And the right wing does just that when they shout, "the U.S. has the best prostate cancer treatment in the world! Universal healthcare will kill men!"

Roughly 50% of 50-year-old men have undiagnosed prostate cancer in autopsies. Of those men, roughly 3.8% of them will go on to die of prostate cancer, generally in their 70's or 80's. This is true whether we are talking about Canada, the United States, Australia, England, France, or any other nation where most of the population is of Western European descent (for some reason Asians seem genetically resistant to prostate cancer and die at a much lesser rate compared to everybody else and we don't have good enough numbers for Eastern Europe yet). In short, most people with prostate cancer are never diagnosed with prostate cancer, and most people with prostate cancer die of something other than prostate cancer.

Roughly 25 out of every 100,000 men of Western European descent will die of prostate cancer in any given year. This is true whether you are talking about the US, Canada, the UK, France, Australia, or New Zealand:

The MORTALITY RATE -- the dark blue line -- is roughly equal amongst all the nations populated primarily by Western Europeans. The INCIDENCE RATE -- the rate at which we diagnose prostate cancer -- varies wildly however. The U.S. has very effective detection of prostate cancer, thus the incidence rate is much higher than in other nations. Because we diagnose more prostate cancers, the number of deaths as a percentage of diagnosed prostate cancers is lower than in other nations, which is the figure that the tighty righties use to "prove" that the US has better prostate treatment than other nations. But this is an artifact of how often we diagnose prostate cancer. The number of deaths as a percentage of population remains pretty much the same as in other nations with modern healthcare systems and a mostly-European population.

In short, there is nothing exceptional about U.S. treatment for prostate cancer. As many people die in the US of prostate cancer, around 25 per 100,000 population, as in every other modern nation populated by Western Europeans. All that IS exceptional is in how many of the underlying prostate cancers we diagnose and treat -- most of which would have no effect on life span if left alone. That's what the mortality rates say, and when the tighty righties try to spin over-treatment that has no effect on mortality rate as "better prostate treatment", it's spin -- that's all.

-- Badtux the Healthcare Penguin

Note: Some may question why the U.S. and Canada are lumped together as "North America" on the above graph. That's because prostate cancer mortality rates are indistinguishable between Canada and the United States -- despite Canada spending half as much on healthcare!


  1. Excellent post, BT.

    Didn't realize that Asians are much less affected. This could be genetic, or a result of dietary differences: less fat, less meat, more fish and veggies.
    Or something else I'm not clever enough to think of.

    I have the impression that prostate cancer is the ultimate end of the line for guys - if nothing else gets you first. It got my dad, when he was about my age, though he lived a few more years.

    So - before something bad happens, why don't you get a new guitar!

    JzB the prostate-enlarged trombonist

  2. As explained above, most people with prostate cancer end up dying of something else. So yeah, keep an eye on that prostate in case it decides it's going to go ballistic, but chances are quite good it isn't going to kill you -- it gets only 2.8% of guys in the end, after all.

    Regarding dietary differences for the Asian prostate cancer difference, that doesn't seem to be it. Asians who've emigrated to the US and Canada also have much lower mortality from prostate cancer. It's one of those differences that survive different diets and different medical systems, like higher infant mortality rates for people of African descent (which is true in the US, Canada, *AND* France), that nobody can explain other than to finally shrug and say "has to be something genetic".

    - Badtux the Healthcare Penguin

  3. Jesus H Kereist in a hand cart. I just had to send a nastygram to Mitch Albom, of all people.

  4. Ooops. Here's a live link.

    JzB the unreliably linking trombonist

    WV: phalings. You really can't than these things

  5. Uh ... plan these things.

    JzB the poor proofreading trombonist

  6. Thought y'all might like this one.. ;-)

    In the space of one hundred and seventy-six years the Lower Mississippi has shortened itself two hundred and forty-two miles. That is an average of a trifle over one mile and a third per year. Therefore, any calm person, who is not blind or idiotic, can see that in the Old Oolitic Silurian Period, just a million years ago next November, the Lower Mississippi River was upwards of one million three hundred thousand miles long, and stuck out over the Gulf of Mexico like a fishing-rod. And by the same token any person can see that seven hundred and forty-two years from now the Lower Mississippi will be only a mile and three-quarters long, and Cairo and New Orleans will have joined their streets together, and be plodding comfortably along under a single mayor and a mutual board of aldermen. There is something fascinating about science. One gets such wholesale returns of conjecture out of such a trifling investment of fact.

  7. This comment has been removed by a blog administrator.

  8. Let me say, Badtux that I have found your posts on health insurance issues very informative. Maybe you should create a third blog dedicated entirely to health insurance news since you have so much information to share on it. However, I am not sure if you would be able to handle a third blog in addition to this one and Mototux.

    Keep posting my little black and white friend.

  9. Seems like everyone is trying to fool everyone. I don't know what to think/believe anymore.


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