Bush lied a lot in 2000. He won. So what's Rudy to worry about? Unless we actually see a real press emerge.

Dean- it's "prostate" not "prostrate".

Rudy may have this number wrong but I recall reading reports of a study (this was several months ago) that showed that 5 year survival rates for cancer were significantly better in the US than most other western countries (though oddly, if memory serves) the report failed to mention France.

Anyway, the reason you site for prostate cancer would not account for the differences with several of the other cancers. What is your reaction? Obviously you shouldn;t take my vague memory's word for it but it did seem to indicate that we were doing something better with cancer in the US.

Please: prostate, not prostrate.

Spelling error corrected -- thanks.

On the comparison of survival rates for other types of cancer, I have heard this claimed, but have not seen the study. While I would like to think that we do get something as a result of spending twice as much money as everyone else, I also know that there is lots of money from the health care industry to pay for bogus studies. So, I would be suspicious of these numbers until I had a chance to look at the study myself.

Don't you mean "had prostate cancer', not "has prostate cancer"?

"I also know that there is lots of money from the health care industry to pay for bogus studies."

OK, Dean. Whatever you say.

But while Krugman was right to blast Guliani, there was no point in his hand waving with claiming the numbers are "the same."

I pointed out here months ago that breast cancer also had a higher survival rate than in the UK, and you gave the same answer.

But neither you nor Krugman have done any careful analysis of this to be able to simply declare "equality".

And being able to test more people earlier is part of the overall system enjoyed by Americans.

Via Kevin Drum, Ezra Klein has the chart that explains Rudy's error. Essentially it appears that all W. Europe and the US have the same mortality rate, we just find more prostate cancers.

http://ezraklein.typepad.com/blog/2006/05/i_wonk_because_.html

Erik L wrote, Rudy may have this number wrong but I recall reading reports of a study (this was several months ago) that showed that 5 year survival rates for cancer were significantly better in the US than most other western countries (though oddly, if memory serves) the report failed to mention France.

The problem is that five-year survival rates are useless figures.

The reason is alluded to by commenter mcdruid.

The only time five-year rates are meaningful is if there's an appropriate control; many (probably most) five-year survival rates cited don't have this.

Gilbert Welch wrote an entire book discussing this: Should I Be Tested for Cancer? Maybe Not, and Here's Why

gladstone wrote, I pointed out here months ago that breast cancer also had a higher survival rate than in the UK, and you gave the same answer.

Again, five year survival rates don't mean anything, except in certain situations (e.g., two drugs being compared, with randomized assignment).

And being able to test more people earlier is part of the overall system enjoyed by Americans.

It might be good to be tested earlier. It might also be bad, if the testing doesn't actually improve mortality and merely creates angst due to false positive, problems due to unnecessary biopses, etc, and increased expenses.

Of course 5 year survival rates mean something.

Krugman and Baker think they are important enough to state that they are essentially equal.

If so, I'd like to see something backing up that statement rather than just hand waving.

I often had to hand wave in Parliament, but always felt more comfortable when I had something more solid to back my claims,

Let me try to explain the problem of 5-year survival rates again, in the absence of any serious control. At any point in time, some percentage of the population has cancer X. Let's hypothesize that it is the exact same percentage (I know it isn't, but let's just keep things simple.)

Now lets' assume that the cancers have a wide range of severity both because people are at different stages and that not everyone will die from cancer even left untreated.

Now let's assume that there are large differences in screening. In country A (let's call it Socialist Medicine Land), people only get screened when they have developed serious symptoms. In country B (let's call it the United States) everyone gets screened all the time.

Now, given the range of cancers in the two countries, since everyone is getting screened in the U.S., while only very sick people get screened in SML, we should expect much longer survival rates in the U.S.

gladstone wrote, Of course 5 year survival rates mean something.

(yawn)

It's funny when someone who is a professed technophile doesn't even know how to use Google.

I mentioned Gilbert Welch above; he makes the point Dean makes. Here's a relevant google search:
gilbert welch five-year survival rate.

For example, from "Warned, but Worse Off":

A second thought experiment helps further understand why CT scans, which find so many minute, nonprogressive tumors, inflate survival rates. Imagine a city in which 1,000 people are found to have progressive lung cancer following evaluation for cough and weight loss. At five years after diagnosis, 150 are alive and 850 have died: a five-year survival rate of 15 percent. However, if everyone in the city were screened with CT scans, perhaps 5,000 would be given a cancer diagnosis, although 4,000 would actually have indolent forms. These 4,000 would not die from lung cancer in 5 years, and the five-year survival rate would increase dramatically - to 83 percent - because these healthy people would appear in both parts of the fraction: 4150/5000. But what has really changed? Some people have been unnecessarily told they have cancer (and may have experienced the harms of therapy), and the same number of people (850) still died.

This is Welch's book on the matter of cancer screening: Should I Be Tested for Cancer?: Maybe Not and Here's Why

But it isn't the case that doctors have been detecting micro tumors in large numbers that hang around harmlesssly in the lung. Nor where they when the comparisons were made in the late 90s (through 2002).

Here is the logic of the good doctor in a letter he wrote to a journal:

"The method used by Richards et al might lead one to conclude that the deaths of tens of thousands American men have been avoided through improvements in early diagnosis and treatment. The fact of the matter is that prostate cancer mortality in the United States is now slightly higher than it was in 1950."

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Of course, considering that life expectancy is higher now than in 1950 where prostate cancer is much more likely to occur today in the far larger elderly population.

He ignores this.

gladstone wrote, Of course, considering that life expectancy is higher now than in 1950 where prostate cancer is much more likely to occur today in the far larger elderly population. He ignores this.

(1) Logical fallacy. Whether or not Welch is correct about that issue doesn't bear on the validity of his claim that 5-year survival rates in the absense of controls are meaningless.

(2) How do you know he ignores it?

Looking through to what appears to be the likely referenced article, at http://seer.cancer.gov/publications/prostate/inc_mort.pdf (the original link died), the rates are age-adjusted. (See e.g. table "Prostate Cancer Mortality Rates, 1973-1995" footnote: "Rates are age-adjusted to the 1970 U.S. standard.")

gladstone wrote, But it isn't the case that doctors have been detecting micro tumors in large numbers that hang around harmlesssly in the lung. Nor where they when the comparisons were made in the late 90s (through 2002).

(a) How do you know that?

(b) Even were it true, it wouldn't negate the claim that five-year survival rates are meaningless.