From NBC/NJ's Matthew E. Berger
On its face, the numbers are startling. According to the latest Giuliani campaign radio ad, the survival rate for prostate cancer is almost twice as high in the United States as it is in Great Britain. But cancer experts suggest the numbers used by the Giuliani campaign are out of date and misleading.
"My chance of surviving prostate cancer, and thank God I was cured of it, in the United States, 82 percent," Giuliani says in the ad, now running in New Hampshire. "My chances of surviving prostate cancer in England, only 44 percent under socialized medicine."
The Giuliani campaign cites City Journal, a conservative quarterly magazine, as its source. The journal's Web site describes it as "the nation's premier urban-policy magazine" and says it served as an "idea factory" during Giuliani's tenure as New York City mayor. It's an arm of the Manhattan Institute, a conservative think tank.
The fact came from an article this summer entitled, "The Ugly Truth About Canadian Health Care." It says that the prostate cancer survival rate is 81.2 percent in the United States, 61.7 percent in France and 44.3 percent in England. But author David Gratzer doesn't provide a source for those numbers. His office said they got the numbers from a 2000 Commonwealth Fund report.
The British government's National Statistics Web site lists prostate cancer survival from 1999 to 2004 at 74.4 percent. The American Cancer Society says 99.9 percent of Americans survive prostate cancer.
Cancer experts say survival rates may also not be the best indicator because there is more prostate screening in the United States than the United Kingdom. Survival rates show the percentage of people who are living five years after diagnosis, whereas mortality rates show the number of people who actually die from the disease.
Age-standardized prostate cancer mortality rates are 15.4 per 100,000 people in the United Kingdom and 12.0 per 100,000 in the United States, according to the American Cancer Society.
"The former New York City mayor is an avid reader of City Journal and found the passage in the article himself," says Giuliani campaign spokeswoman Maria Comella. "He cited the statistics at a campaign stop, and the campaign used a recording from that appearance in the radio advertisement.
"The citation is an article in a highly respected intellectual journal written by an expert at a highly respected think tank which the mayor read because he is an intellectually engaged human being."
*** UPDATE*** Dr. Patrick Walsh, a prostate cancer expert from Johns Hopkins Hospital in Baltimore, said there is no doubt that screening and treatment for prostate cancer in the United States is better than in England, but said the numbers don't tell the whole story.
"I don't know where Giuliani got those numbers," said Walsh, a university distinguished service professor of urology. "You can't exactly compare death rates" because many prostate cancer patients technically die of pneumonia.
Walsh said that when he travels to England, he sees patients frustrated with the level of national care.