This BBC article:
"The US had the highest five-year survival rates for
breast cancer at 83.9% and prostate cancer at 91.9%... The UK had 69.7%
survival for breast cancer... and 51.1% for prostate cancer."
Those numbers would seem to means that in the
UK breast cancer patients are almost twice as likely to die within 5 years, and
prostate cancer patients are six times as likely to die within 5 years,
compared to the USA.
However, the BBC’s prostate
cancer numbers require some explanation, because PSA tests are much more widely
used in the USA than in the UK, which changes the meanings of some of the statistics.
I did some
checking, and found better numbers for prostate cancer in the US and UK. The bottom line is that if you contract
prostate cancer in the UK you are much more likely likely to die from it than
if you contract prostate cancer in the USA.
But the difference is closer to 2x rather than 6x.
Let’s compare the two countries:
UK Population (2006): 60.588 million
UK Population (2007): 60.975 million
UK population male v. female (from 2001 census):
male: 29,782,086 = 49.41%
female: 30,488,622 = 50.59%
UK Male population (2006) (calculated as 49.41% of total): 29.939 million
UK Male population (2007) (calculated as 49.41% of total): 30.130 million
UK new prostate cancer cases (2006): 35,515
Rate per 100,000 male population (given): 97.1
Rate per 100,000 male population (calculated): 118.6
UK prostate cancer deaths (2007): 10,239
Rate per 100,000 male population (given): 24.6
Rate per 100,000 male population (calculated): 34.0
US Population (2008 est.): 304,059,724
US Male population (2008) (calculated as 49.3% of total): 149.901 million
= 4.98 times the UK's 2007 male
US new prostate cancer cases (2009 projected): 192,280
"Age-adjusted rate" per 100,000 male population (given): 159.3
Rate per 100,000 male population (calculated from 2008 population): 128.3
US prostate cancer deaths (2009 projected): 27,360
Rate per 100,000 male population (calculated from 2008 population): 18.2
(Yes, I realize that conflating "2009 projected" diagnosis and
mortality numbers with 2008 population numbers introduces some error, as does
comparing 2008/2009 numbers in the USA with 2006/2007 numbers in the UK, but
the errors are small.)
1. The US diagnosis rate is about 9% higher than the UK diagnosis rate,
presumably because PSA tests are used much more widely in the USA.
Adjusting for that difference would reduce the BBC's reported 6:1 ratio in 5yr
prostate cancer survival rates to about 5.5-to-1.
2. The wider use of PSA tests in the USA probably results in earlier
diagnosis of prostate cancer, which means that "5 years from
diagnosis" the disease has not progressed as far for the average US
patient as for the average UK patient.
A better measure would be length of survival from date of disease onset,
but that is impossible to know.
3. The US prostate cancer fatality rate is much lower than UK's, but not
by nearly the BBC's
reported 6:1 ratio. With only 20% of US male population, the UK
nevertheless has about 37.4% as many prostate cancer deaths as the US.
Coincidentally, that's almost exactly the same as the 1.9x ratio which
the BBC reported for breast cancer, but much smaller than the 6x difference in
5 year death rates which the BBC reported for prostate cancer.
Now, prostate cancer is a disease which exclusively strikes the elderly, and I
think that the UK population is somewhat older than the US population, which
probably accounts for some small part of that difference, but it certainly
can't account for all of it. The bottom
line is that someone who contracts prostate cancer in the UK is nearly twice as
likely to die from it as someone who contracts prostate cancer in the USA.
The difference has been noted elsewhere, such as this article:
which says, in part:
"The decline in
mortality from prostate cancer in the USA is striking in
comparison to the UK, but we can only continue to speculate
relative contributions of differences in detection and treatment..."
"in both countries,
mortality rates were at their highest in the early
1990s and were at almost the same rate. The
divergence occurs after this
period, as the mortality rate decrease in the USA (4.17% per year) was
about four times the rate in the UK (1.17% per year). Patients aged 75 or
older in the USA saw the largest and longest lasting decline in mortality
rates, but rates had stopped declining in this group in the UK by the
In other words, in the UK the elderly are hardest hit by the differences
between the two countries -- which is exactly the result you should expect
from British-style healthcare rationing, which results in much less
aggressive treatment (especially of of slowly progressing cancers like prostate
cancer) in people aged 75 and older.
It would be a mistake to use the BBC's numbers to support a claim that prostate
cancer is 6x as likely to be fatal in the UK than in the US. However, it is safe to say that both breast
cancer and prostate cancer have much higher fatality rates in the UK than in