Cancer Rates and Unjustified Conclusions

[Renew Deal]

A number of opponents of new health care legislation, most recently our old friend Betsy McCaughey on "The Daily Show," have claimed that cancer survival rates are higher in the U.S. than in countries with nationalized health care. They conclude from this that the state of general health and health care quality in the U.S. must therefore be higher. Does the U.S. really have a higher cancer survival rate? And what does that mean about our health care system?

It’s certainly the case that we have higher survival rates than the United Kingdom and other countries with nationalized health care. Across the board, the United States boasts a higher five-year relative survival rate than the European average, according to a 2008 study in the British medical journal Lancet. For breast cancer, for instance, the U.S. survival rate was 83.9 percent, the U.K. rate was 69.7, and the average European rate was 73.1.

But survival rates also differ within the United States, between insured and uninsured populations. The American Cancer Society found that the five-year survival rates for colorectal cancer averaged 63 percent for the privately insured but 49 percent for the uninsured. According to the Lancet study, five-year relative survival rates for colorectal cancer were 59.1 percent in the U.S. and 45.3 percent in Europe. Breast cancer survival rates among the uninsured were also similar to Europe – 85 percent survival for those with private insurance, 75 percent for the uninsured, close to the European average. Rates for people on Medicaid were similar to the uninsured.

So universal insurance is as bad as no insurance, right? Not so fast. For one thing, survival rates in Canada, Japan, Australia and Cuba were all comparable to or higher than U.S. survival rates on all types of cancer that the Lancet study examined, except for prostate cancer. Those countries all have some form of government-provided health care coverage. Prostate cancer often doesn’t require treatment, so the aggressive screening common in the U.S. turns up both early cases and cases that would never need intervention. This leads to an inflated survival rate in the U.S., where asymptomatic patients are more likely to be diagnosed.
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http://www.factcheck.org/2009/08/cancer-rates-and-unjustified-conclusions