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August 21, 2007
Cancer Survival Rates
Well, lookie here.
Cancer survival rates in Britain are among the lowest in Europe,
according to the most comprehensive analysis of the issue yet produced.
England is on a par with Poland despite the NHS spending three times more on health care.
Survival
rates are based on the number of patients who are alive five years
after diagnosis and researchers found that, for women, England was the
fifth worst in a league of 22 countries. Scotland came bottom. Cancer
experts blamed late diagnosis and long waiting lists.
In total,
52.7pc of women survived for five years after being diagnosed between
2000 and 2002. Only Ireland, Northern Ireland, Scotland, the Czech
Republic and Poland did worse. Just 44.8pc of men survived, putting
England in the bottom seven countries.
The team, writing in The
Lancet Oncology, found that Britain's survival rates for the most
common cancers - colorectal, lung, breast and prostate - were
substantially behind those in Western Europe. In England, the
proportion of women with breast cancer who were alive five years after
diagnosis was 77.8pc. Scotland (77.3pc) and Ireland (76.2pc) had a
lower rate.
Rates for lung cancer in England were poor, with
only 8.4pc of patients surviving - half the rate for Iceland (16.8pc).
Only Scotland (8.2pc) and Malta (4.6pc) did worse.
Clearly, Our Glorious NHS (the wonder of the world you know, so much so that no one has ever adopted the system) isn't as wonderful as some think. It's also not how much money is spent but how.
Oh, one other interesting point. The US, you know, that place with the re in tooth and claw system? That's top of the cancer survival league.
They must be doing something right.
August 21, 2007 in Health Care | Permalink
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Comments
....but Michael Moore said the waiting lists in Europe were a myth!
Posted by: david | Aug 21, 2007 10:02:26 AM
Mind you, the criterion is obviously iffy: "the number of patients who are alive five years after diagnosis". It confounds two effects, dunnit?
Posted by: dearieme | Aug 21, 2007 11:48:13 AM
A paradoxical aspect to the report about the relatively low cancer survival rates in Britain is that we also have an outstanding international reputation for the quality of cancer research in Britain.
The Royal Marsden Hospital, which specialises in cancer treatment and care, is rated as world standard. With net surfing, I've often noticed how quickly international media pick up and report on research bulletins that hospital puts out.
One explanation for this curious gap between Britain's high rating in cancer research and the relatively low survival rates relates to the extent of systemic delays in diagnosis and treatment.
A true, personal story yields insights. Last Friday, I received from my local hospital a letter asking me to return to the Pathology Department so they could take another blood sample as they didn't take sufficient blood when I had visited recently. The reference to "recent" relates, in fact, to blood samples taken in April for a range of tests requested by my GP. Now is August.
The letter is the result of my GP pursuing the hospital last Wednesday after I went to my GP for a routine prescriptions review. A check on the reported results of blood tests requested in April showed that the hospital had not returned a result for a requested standard Prostate test - note: "Prostate cancer is the most common male cancer in the UK, accounting for almost one in four of the male cancers. Each year, nearly 32,000 men in the UK are diagnosed with prostate cancer and more than 10,000 die from it."
http://www.bbc.co.uk/health/conditions/prostatecancer1.shtml
Last year I had a problem with an eye screen when it took 6 months to report that there was no identified problem and that only after pressure and a letter - I gathered from my GP at the time that there were several similar cases of delayed reporting.
A primary problem causing low survival rates in the NHS is therefore not poor science or bad medicine but grotesquely inefficient administration. Sadly, recent accounts from friends and acquaintances of their personal experiences corroborates this bleak assessment.
Posted by: Bob B | Aug 21, 2007 12:07:13 PM
"It's also not how much money is spent but how."
According to the summary graph here http://news.bbc.co.uk/1/hi/health/6955545.stm
it certainly is about how much money you spend *as well as* how you spend it (like the continental Europeans spend it, seems to be the message).
Posted by: Jim | Aug 21, 2007 1:24:02 PM
Jim: indeed. Rich Yanks' insurers spend millions of dollars on drugs that prolong their lives by a few months; poor Yanks don't even find out they've got cancer until they're nearly dead of it...
Posted by: john b | Aug 21, 2007 3:11:05 PM
It's extremely difficult to "get a handle" on what's actually going on in this particular matter.
If it is true, as I and most believe (and is commonsensical) that even some cases of cancer can be ameliorated to some degree if detected AND it is also true (as I and most believe and is commonsensical) that such success depends to some degree upon the stage at which potentially efficaious treatment is begun, THEN there cannot be any question but that widespread protocols of earlier detection are desirable and will have "some" statistical life-prolongation (and enhancement) effect.
But when the question arises as to "how much?" said benefit amounts to--especially in consideration of that other "how much?" question as to allocated resources (especially compulsorily-obtained and politically-allocated resources), what seemed relatively clear becomes quite murky.
For many years (as long as I've been noticing--perhaps 35 or 40), women have been getting urged to have mammograms and to have them earlier than otherwise--to detect and enable treatment of a widespread, troublesome, often fatal form. Now and then, I'd see a news article (or public-service advertisement) extolling improvement of womens' health due to such earlier detection, urging both more women seeking testing at earlier ages and more resources devoted to a general program of widespread and earlier testing.
I began to wonder--idly--just how much seeming improvement (in "living 5 years after initial diagnosis") was an artefact of earlier detection. At one extreme, it could be possible not a single outcome might be changed--that each woman who'd have died at a particular time-distance from an older testing regimen still died at the very same time but further from an "improved" earlier testing date. One couldn't really make out what was the case from the stories and ads; indeterminable was whether neglect of that aspect were due to logical and scientific ignorance of reportorial/editorial staff or mendacity of scientific and health-care industry officialdom.
I don't know exactly when I became aware that others were cognizant of the possiblity I'd imagined; I quit reading newspapers and magazines in 1980 and subsequently got whatever news I needed from TV or by osmosis. After about 1999, I read exerpted news articles on the net and somewhere saw expressed a statement to the effect that things were exactly as I'd hoped they weren't: that most touted improvement was illusory--almost as though no outcomes had changed, merely an earlier 5-year slice selected with which to paint a statistical (and fund-raising) picture.
Long ago, Frederic Bastiat emphasized that the importance of economic analysis lay in appreciating the totality of consequences of policy actions--by paying due attention to the "long run." Thus, although J. M. Keynes declared (in viewing results of authoritarian economic intervention) that we'd achieved the "miracle of turning stone into bread." Few read Von Mises' comment that what had been achieved was the by-no-means miraculous effect of having eaten one's seed corn. Few today dispute the truth of Mises observation and Keynes' is much diminished; but policies he espoused and, more importantly, a view of authority as the legitimate prime mover in the affairs of men--has barely been dimmed.
It is customary that the Left, as one of its standard tropes, emphasizes that its ideological opponents, those who insist on the importance of free markets (and market freedom) would give free reign to frauds and charlatans and excuse and increase the influence of the avaricious, the penny-
pinching, money-grubbers solely seeking profit wrested from the toil of the vast majority and successful mainly on account of the latter's ignorance and lack of organization. No quibble is necessary to emphasize that mens' negative qualities and motives cannot be eliminated, may be (are) lurking beneath the surface where time and again they'll interfere with any idea of prosperity and social justice for all; the free market does not pretend (or intend) to make men other than they are.
But the Left errs and very badly: not necessarily in misjudging men and their motives but rather in assuming that such will not be equipresent in whomever is constituted as authority and failing to appreciate the degree to which authority is also a powerful means with which to effect the illegitimate ends feared from operators, big and small, on the market. Authority lies, cheats, steals, assaults, enslaves, beats into submission, tortures, and kills. In the better polities, it does not often engage in most such activities. But in none, even the best, does it not do such things, even, frequently, by mistake rather than intentionally--quite simply because doing these things to malefactors or would-be malefactors are what they--and everyone else--consider their very reason for existence. The idea of a "liberal" government--restricted in the scope of its activities vis-a-vis ordinary individuals--is of relatively recent provenance, nowhere fully realized, under continual assault from many of the same quarters as proclaim dedication to liberal principles. Can it be that the same people who extoll the fictitious renderings of "Brave New World," Asimov's "Foundation Trilogy," or "Fahrenheit 451" cannot detect applicability of the underlying substrate to their own existence, as they argue for yet larger roles for coercion extended to nearly every aspect of life (whether seat-belt laws, waste recycling, global "warming,"
or, in provision of health information and services.
I say none of these things for applause from those on my "side." Nor do I wish to (and won't) debate points with those opposed. My purpose is to address some (whom I cannot even identify with any precision) whose espousal of leftist (socialist, "liberal"--in the U.S.--progressive, environmentalist, anti-racist, etc.) policies and solutions proceeds primarily from the nebulous desire that the world in which we live become a better place in which to do it, not only for the present but for that period of the future over which we can have any effect. All I can hope is that some of those will think about what they think; it actually does matter.
Posted by: gene berman | Aug 21, 2007 5:33:56 PM
