Friday, August 24, 2007
The Lancet (free registration) released data showing that the United States having the best survival rate for cancer. This is great news! Ezra Klein analyzes further what this information really means. He writes,
Andrew Sullivan is quite pleased that the US is #1 in cancer survival rates. So am I! Problem is, we don't know what that means. The US has the most aggressive tumor screening in the world. That means we find some tumors earlier, but we also find many tumors that would have been non-lethal, or proven so slow-growing that something else would have killed the individual before the cancer did. In those cases, our treatments are, at best, an enormous waste of money, and at worst, more damaging than the disease. The question is how many otherwise lethal cancers we're curing, not merely how many cancers we're curing (or slowing).
Moreover, simply having the highest survival rates isn't a particularly useful metric of whether we're getting good value for our money. Our 5-year cancer survival rate, according to the study Andrew links, is 62.9%. Italy's is 59%. Italy spends about $2,532 per person. America spends about $6,100. And these numbers, incidentally, are adjusted for purchasing power parity. Then there's the question of who our treatment is best for. Not the poor. Studies show significantly lower mortality rates for the low-income cancer patients in Canada than in the US. Is this all a good deal? Maybe. But Sullivan should explain why we should believe that. . . .
For a different take, see the Ayn Rand Institute.