Still a bit crazed from the cross country flight. These things affect me for longer than they do most people; but I did have a quick initial look at the health data from which the figures you quote seem to be derived.
You may be correct, but I believe there are some problems with the data that need to be addressed before I could actually agree with you. Not a large surprise there, I suppose, but the issues are real enough to my mind. The European data seems to be from actual statistics from folks whove come in with various forms of cancer and whove gotten treatment in the various government and private facilities in those places. The data is pretty solid and not what Id consider particularly worth being thrilled about in general. More machines and better access to meds are probably a good thing in many cases, though not necessarily in all cases. In one of the sources Denise quotes, for example, the folks brag about the higher ratio of Papp smears and Mammograms given as well as the high number of prostate cancer screenings that are given here in the states. This may not in fact be the best standard of care, and there is an ongoing medical debate about it. Charities who want high awareness focused on their illnesses are always in favor of these tests for good reasons. Not only does the money continue, but far more importantly, their particular illness may be dealt with more quickly. Its not all greed, after all.
While the number of cases that the European data is based on are much closer to 100% of the actual cases in the population, because the reporting is widespread, this is far from the case in the United States. SEER, the governmental statistics keeper here, only was able to present about 26% of the population for study in the year 2001, which was one of the two years the study in the Lancet Oncology Issue studied.
The reference to the SEER data is this:
and here is an excerpt:
The NCI has recognized the need to better define the cancer burden in racial/ethnic minorities and medically underserved populations and supports research, applications and surveillance on the full diversity of the United States population. Since its inception in 1973, the the cancer registry system of the SEER Program has included large segments of diverse populations. Subsequent expansions increased the proportions of Hispanics, urban African Americans and Asian and Pacific Islanders in Southern California and the Greater Bay Area, rural African Americans in Georgia, northwestern populations in Seattle, Arizona Indians, and Alaska Natives residing in Alaska. An expansion in 2001 of four areas increased coverage of key populations, such as rural low-income whites, more geographically diverse American Indians, rural African-Americans and other Hispanic groups. This addition the largest expansion to date brings SEER coverage to 26% of the U.S. population.
26%, by the way, would usually be considered a stellar sample size, but in this case, this was a large change from the nature of the previous sample in terms of racial and ethnic diversity as well as geographic diversity, including a large apparent influx of rural populations. Tossing this population in the middle of a two year size sample is indeed something that could throw the data off significantly, and should have been compensated for in some fashion in the statistical model.
Since I dont have the money to buy access for a fuller version of the article, I dont know what was done here.
Nor do I know what the effect of having a large proportion of the US population not available to have their data reported upon due to poverty and other lack of access problems. Medical care for these folks, when it is available, tends to be available in a sporadic fashion.
A look at the actual data from The Lancet Study seems to me by the way somewhat different than the data that Denise presented, and should be looked at more closely before the conclusions Denise offers could be supported.
You should probably judge the conclusions for yourselves rather than accept the carefully cherry-picked and somewhat slanted data offered by the folks who have a political rather than a scientific point to make. Here are the findings direct from the synopsis of the article. The reference is below for your follow-up pleasure:
For all cancers, age-adjusted 5-year period survival improved for patients diagnosed in 200002, especially for patients with colorectal, breast, prostate, and thyroid cancer, Hodgkin's disease, and non-Hodgkin lymphoma. The European mean age-adjusted 5-year survival calculated by the period method for 200002 was high for testicular cancer (97·3% [95% CI 96·498·2]), melanoma (86·1% [84·388·0]), thyroid cancer (83·2% [80·985·6]), Hodgkin's disease (81·4% [78·984·1]), female breast cancer (79·0% [78·180·0]), corpus uteri (78·0% [76·279·9]), and prostate cancer (77·5% [76·578·6]); and low for stomach cancer (24·9% [23·726·2]), chronic myeloid leukaemia (32·2% [29·035·7]), acute myeloid leukaemia (14·8% [13·416·4]), and lung cancer (10·9% [10·511·4]). Survival for patients diagnosed in 200002 was generally highest for those in northern European countries and lowest for those in eastern European countries, although, patients in eastern European had the highest improvement in survival for major cancer sites during 19912002 (colorectal cancer from 30·3% [28·332·5] to 44·7% [42·846·7]; breast cancer from 60% [57·263·0] to 73·9% [71·776·2]; for prostate cancer from 39·5% [35·044·6] to 68·0% [64·272·1]). For all solid tumours, with the exception of stomach, testicular, and soft-tissue cancers, survival for patients diagnosed in 200002 was higher in the US SEER registries than for the European mean. For haematological malignancies, data from US SEER registries and the European mean were comparable in 200002, except for non-Hodgkin lymphoma.
The Lancet Oncology, Volume 8, Issue 9, Pages 784 - 796, September 2007