A study published in 2012 argued that money spent in the United States on health care, specifically cancer, is worth it.
The researchers found that the increase in survival equated to more than $500 billion in additional value, more than the difference in spending. That study was published in health affairs and depended solely on survival rates.
A recent study focused on mortality rates and found that cancer care in the United States may provide significantly less value than that in Western Europe.
Mortality and survival are very different concepts.
However, almost all research in this particular area uses survival rate as the metric.
For survival rates, doctors enroll patients upon diagnosis and follow them for a set number of years and measure how many survive. Conversely, mortality rates are a population metric; they describe the population as a whole and are much harder to measure accurately.
Mortality rates are determined by taking the number of people who die of a certain cause in a year and dividing it by the total number of people in a population. For example, the mortality rate for men with lung cancer in the United States is 61.6 per 100,000. This data comes from the Seer database.
On the other hand, survival rates describe the number of people who live a certain length of time after a diagnosis. For example, the five-year survival rate for people diagnosed with lung cancer is 16.8%.
Unfortunately, survival rate is the information patients want. When patients are diagnosed with cancer, they want to know the likelihood that they will live a certain amount of time, mortality rates won’t mean anything to them.
However, survival rates are known as lead-time bias. Mortality rate can be decreased by preventing people with the disease from dying or preventing them from getting the disease in the first place. While survival rates can be improved by preventing death, preventing people from getting sick or making the diagnosis earlier.
Mortality rates have remained unchanged, because the same relative number of people are dying every year. On the contrary, survival rates have increased by moving up the time of diagnosis and potentially subjecting people to five more years of therapy. No real improvements were made.
Looking at the wrong data has falsely led people to believe that the current spending on cancer is sufficient, when in reality it is not.
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