Is America’s Cancer Care World Class?

U.S. life expectancy after cancer diagnosis is higher than that those for ten European countries.  A recent study in Health Affairs cites these statistics as evidence that the more expensive treatments American physicians employ is worth it.

We found that US cancer patients experienced greater survival gains than their European counterparts; even after considering higher US costs, this investment generated $598 billion of additional value for US patients who were diagnosed with cancer between 1983 and 1999. The value of that additional survival gain was highest for prostate cancer patients ($627 billion) and breast cancer patients ($173 billion).

Some critics are not convinced.

‘This study is pure folly,” said biostatistician Dr. Don Berry of MD Anderson Cancer Center in Houston. “It’s completely misguided and it’s dangerous. Not only are the authors’ analyses flawed but their conclusions are also wrong.’

Why aren’t some experts convinced?  Philipson and colleagues look at survival rather than mortality.  Survival means how long the patient lives after the patient is diagnosed with cancer. One thing the U.S. is good at is screening for cancer.  Thus, patients may be surviving longer not due to better care, but because because these patients are diagnosed earlier.  U.S. mortality rates from cancer are no better than in Europe.

Another problem with the American approach is over-diagnosis.  According to Doverdiagnosis.  From Merrill Goozner:

Because cancer screening is much more widespread in the United States than in Europe, especially for breast and prostate cancer, ‘we find many more cancers than are found in Europe,’ [Dr. Berry] said. ‘These are cancers that tend to be slowly growing and many would never kill anyone.’

Screening therefore turns thousands of healthy people into cancer patients, even though their tumor would never threaten their health or life. Counting these cases, of which there are more in the United States than Europe, artificially inflates survival time, experts said.



Leave a Reply

Your email address will not be published. Required fields are marked *