from the ripped-off-and-kicked-right-out-of-bed dept.
“There is a common perception that the U.S. offers the most advanced cancer care in the world,” said lead author Ryan Chow, an M.D./Ph.D. student at Yale. “Our system is touted for developing new treatments and getting them to patients more quickly than other countries. We were curious whether the substantial U.S. investment on cancer care is indeed associated with better cancer outcomes.”
The United States had the highest expenditure rate among the 22 high-income nations examined.
“The U.S. is spending over $200 billion per year on cancer care — roughly $600 per person, in comparison to the average of $300 per person across other high-income countries,” said senior author Cary Gross, professor of medicine and director of the National Clinician Scholars Program at Yale. “This raises the key question: Are we getting our money’s worth?”
The researchers found that national cancer care spending showed no relationship to population-level cancer mortality rates. “In other words, countries that spend more on cancer care do not necessarily have better cancer outcomes,” said Chow.
In fact, compared to the United States, six nations — Australia, Finland, Iceland, Japan, Korea, and Switzerland — had lower cancer mortality and lower expenditure on the condition.
Smoking is the leading cause of cancer death, and smoking rates in the United States have generally been lower than in other nations. When the researchers controlled for international differences in smoking rates, the researchers found that the United States’ cancer mortality rates were no different than those of the average high-income country, with nine countries — Australia, Finland, Iceland, Japan, Korea, Luxembourg, Norway, Spain, and Switzerland — having lower smoking-adjusted cancer mortality than the United States.
“Adjusting for smoking shows the United States in an even less favorable light because the low smoking rates in the U.S. had been protective against cancer mortality,” said Chow.
Reference: “Comparison of Cancer-Related Spending and Mortality Rates in the US vs 21 High-Income Countries” by Ryan D. Chow, Ph.D., Elizabeth H. Bradley, Ph.D. and Cary P. Gross, MD, 27 May 2022, JAMA Health Forum.
DOI: 10.1001/jamahealthforum.2022.1229
(Score: 2) by hubie on Wednesday July 20 2022, @11:58PM (8 children)
Mathematician Hannah Fry has a very interesting take on cancer diagnosis and treatment, from a patient's perspective. She was diagnosed with cervical cancer and this documentary covers how she approached it and the questions she asked. It is supposedly very good, but I have to wait for it to show up somewhere where I can watch it outside the UK: Making Sense of Cancer with Hannah Fry [bbc.co.uk]
If anyone has seen it I would be interested in what you thought. The points she pokes at seems to agree with this article.
(Score: 1, Informative) by Anonymous Coward on Thursday July 21 2022, @02:25AM
It appears to be available on bittorrent. Torrent name is "Horizon.S61E03.Making.Sense.of.Cancer.with.Hannah.Fry.1080p.HEVC.x265-MeGusta[eztv.re].mkv" and it's only 544 MB, with 2 active seeders at the moment (that I can see). The hash is 965c0e4753e978846e47b7884386de71c47277ed
(Score: 0, Offtopic) by Runaway1956 on Thursday July 21 2022, @03:05AM (6 children)
First thing first: The lady has lovely hair, and both her daughters have her hair. She's nice to look at, and she's easy to listen to. Guess I've heard her name in the past, but I didn't know anything about her. Now I've "met" her in the video, and she's easy to relate to.
About 21:30, she's pretty well laid out statistics, and the problems with cancer are pretty well established. "I'm feeling conflicted. I'm uneasy that patients might not see how small the benefits are, but I know what it's like to be frightened, and just want a doctor to take charge."
Around 28:00 she is interviewing Nina. The takeaway is, if there was only a 1% chance that chemo would help, she would take that chance.
Abortion is the number one killed of children in the United States.
(Score: 2, Interesting) by Runaway1956 on Thursday July 21 2022, @03:45AM (5 children)
Ooops. Meant to hit "preview" and hit the other button.
About 30:00 Hannah explains that not many doctors opt for the chemo when faced with the choice. Doctors want a 25% chance of success before they seriously consider a course of treatment for themselves.
Hannah's cancer is looking good - results say she is cured . . . but only a couple minutes later, around 34:00 she's experiencing swelling in her legs. . . . so, pressure garments, much like burn patients get while healing. Lymphadema is being described as more traumatic than the cancer was . . .
Few patients feel that the side effects of cancer treatments are properly explained to them,
Whoa. Surprising bit starting around 44:00. Dr. Margaret McCartney interview. The doctor explains that about 7% of deceased people who die of various causes are found to have some form of cancer in their systems. Traffic accident victims, etc, who were not being treated, or even tested, for cancer, have cancer. Hannah has been building up to the idea that cancer treatments really aren't worth the time, effort, expense, side effects - and now she is developing the idea. "If you go and look for cancer, you will find cancer."
By around 54:00 or 55:00 she has moved on to philosophical ramblings. Basically, stop worrying so much about cancer, and get on with life.
Abortion is the number one killed of children in the United States.
(Score: 2) by bzipitidoo on Thursday July 21 2022, @09:19AM (3 children)
Prostate exams for cancer were recommended starting at age 40. Then that was pushed back to 50. Then 55. And, for those over 70, forget it, because something else is likely to kill him well before prostate cancer would.
For women, the big fishing expedition is for breast cancer. Get mammograms every year starting at age 40. As I recall, that too was pushed back to 50.
On medical care, the US most assuredly does not get its money's worth. This has been known for decades.
(Score: 1) by Runaway1956 on Thursday July 21 2022, @10:58AM
I should add how things were done, decades ago, since younger people probably don't know.
Someone would experience a health problem, go to the doctor, get X-rays, and whatever other tests the doctor ordered. No CAT scans, no ultrasound, no MRI back then. X-rays and blood work were about the extent of things. The doctor would suspect cancer, so order "exploratory surgery". If cancer was found during the exploratory, the surgeon attempted to cut it away, then sew the patient back together. It seemed that if cancer was found, the exploratory surgery disturbed everything, flushing cancer cells into the blood stream.
Just like today, doctors told you, "We can only wait and watch to see if we got it all." And, mostly, they didn't get it all.
My non-medical perception was, if you go in for exploratory surgery, you're probably a goner. There were precious few success stories back then, and virtually all of those took place at the most highly acclaimed medical centers around the country, such as Mayo Clinic. "Success" was measured in survival of months, or years, certainly not in decades.
Today, your chances of survival have increased dramatically, but it's still a crap shoot.
It also needs to be noted that today, doctors don't flay you, opening your chest or abdominal cavity, so they can get their hands inside. Procedures today are much more precise, much less invasive, and disturb a lot less of whatever is found in there.
It's almost like comparing the dark ages to the age of enlightenment.
Abortion is the number one killed of children in the United States.
(Score: 0) by Anonymous Coward on Thursday July 21 2022, @12:05PM
Most prostate cancers are like you say, but down in the few percent level there is an aggressive form. A friend of mine ended up with that one and was dead about a year after being diagnosed. Both my father and my father-in-law were diagnosed with the "regular" kind and one chose to have their prostate removed and the other didn't.
(Score: 0) by Anonymous Coward on Thursday July 21 2022, @04:43PM
> On medical care, the US most assuredly does not get its money's worth.
On the contrary, medical care is a market that precisely identifies the value a consumer of its products is willing to pay. This is How It Is as written in the gospels.
(Score: 2) by hubie on Thursday July 21 2022, @12:01PM
Thank you for the summary. She is a very good explainer and deserves all the plaudits she gets for her outreach work. I learned of her through Brady Haran's work [bradyharan.com], particularly Numberphile [numberphile.com], she gave an excellent set of Christmas Lectures [rigb.org] on probability, and I really enjoy her recent podcast series on Artificial Intelligence [deepmind.com].
What intrigued me about this cancer show was the conflict between taking an analytical look at the numbers vs. being the freaked out patient who is inclined to try anything and everything despite what the numbers might say. That is exactly the position that I would be in and I hope I never have to face that.
(Score: 0) by Anonymous Coward on Thursday July 21 2022, @12:08AM
Did we get our money's worth?
(Score: 1, Troll) by Kell on Thursday July 21 2022, @03:27AM (3 children)
Living in the state of California is known to cause cancer in the state of California.
Scientists ask questions. Engineers solve problems.
(Score: 2) by DeathMonkey on Thursday July 21 2022, @02:48PM (2 children)
They get labeled because they ARE carcinogens.
The fact that you seem to be unaware of the dangers these products pose is evidence that we desperately need these labels!
(Score: 2) by Freeman on Thursday July 21 2022, @03:50PM
https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat [who.int]
https://sites.psu.edu/avdh/2015/02/16/carcinogens-in-food/ [psu.edu]
https://www.huffpost.com/entry/17-carcinogenic-foods-you-probably-eat-every-day_n_6108760ee4b0999d2084f9db [huffpost.com]
So, avoid these things:
Alcohol
Red Meat
Meat that has been charred
Really, any food that has been charred
So, no more beer, vodka, etc. and no more Barbecues or grilled anything.
https://www.reuters.com/article/health-meat-california-idINL3N12S17120151028 [reuters.com]
https://news.llu.edu/patient-care/california-s-cancer-warnings-what-are-real-risks [llu.edu]
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 0) by Anonymous Coward on Thursday July 21 2022, @11:05PM
Dude is saying that living in the US is the real carcinogen. Given that US oncology care doesn't appear to be as effective as elsewhere, maybe they have a point?
(Score: 2) by Mykl on Thursday July 21 2022, @04:28AM
My outsider's take on the US Health system is that it is designed to benefit the rich (no surprise, that's what all of US society is designed to do). I absolutely believe that the US Health system provides worse care on average for patients, but the top end do get pretty good treatment.
Is this also the case for Cancer? In other words, is the US the best place to go if money is no object, or are they no better than other countries regardless of how much money you have?
(Score: 3, Insightful) by Opportunist on Thursday July 21 2022, @05:09AM (4 children)
The US has one of the most expensive and at the same time not exactly one of the best medical systems in the western world. And you think we "might" not get our money's worth out of it?
MIGHT?
(Score: 0) by Anonymous Coward on Thursday July 21 2022, @09:41AM (2 children)
As I understand it, the medical care for the inner party is the best in the world. The outer party care is about as good as the rest of the developed world. The outer party basically funds both their own ordinary care and the development of the exemplary inner party care. The proles without health cover get to pay exorbitant fees on a per treatment basis for shitty care.
If you have health cover and are not sure if you are inner or outer party, then you are outer.
(Score: 1) by Runaway1956 on Thursday July 21 2022, @10:40AM (1 child)
I altered your statement slightly to reflect the fact that many simply cannot afford the care they need. Much of the blame for that falls on insurance companies.
I related recently that a lady acquaintance has hernias, which are quite bad. She has health insurance, through her employer. She's been paying that insurance for decades. The insurance company insists that the hernia operation is voluntary and cosmetic, so they won't pay for it. That is ridiculous. Hernias can be, and are, life threatening in many instances. No doctor, no insurance company, can look at the hernias, and say "This hernia is not life threatening."
If she manages to convince the insurance company to pay, they will likely only pay a small portion of the cost, leaving her holding the bag.
I've not yet convinced her to just get it done on her own. Going to a surgeon and telling him that she has no insurance is very likely to result in the prices being reduced. The surgeon, hospital, and anesthesiologist along with ultrasound should come out to a ballpark figure of $1800 to $2000. That's a large chunk of change for someone who work at near minimum wage, raising kids.
Abortion is the number one killed of children in the United States.
(Score: 0) by Anonymous Coward on Thursday July 21 2022, @08:28PM
Yeah, the lines aren't quite as clear as in the book. Your friend is on the border between outer party (has insurance) and prole (pay as you go or die).
(Score: 2) by DeathMonkey on Thursday July 21 2022, @02:51PM
We have a terrible healthcare system.
And yet our cancer outcomes are the same as places with better healthcare systems.
Therefore, our cancer science must actually be better to account for the difference.
To present an alternate hypothesis.....