Rudy Giuliani's Prostate

02 November 2007

Rudy Giuliani has a new campaign advertisement about his prostate:

According to Rudy Giuliani, “My chance of surviving prostate cancer — and, thank God, I was cured of it — in the United States? Eighty-two percent. My chance of surviving prostate cancer in England? Only 44 percent under socialized medicine.” There are a few problems with this, though.

(1) The statistic is just plain wrong.

The former New York mayor did survive prostate cancer, but otherwise his statistical claims were not difficult to debunk, as reporters for the New York Times, the Washington Post, MSNBC and other news outlets quickly discovered. Giuliani had picked up his numbers from an article in City Journal, a publication of the right-wing Manhattan Institute, and simply repeated them in public without bothering to check their validity. Unfortunately, they were essentially fraudulent figures, extrapolated inaccurately from old data (by a doctor who also advises the Giuliani campaign on healthcare).

Accurate and current data, easily available from public health agencies and medical authorities, shows that the survival rate from prostate cancer in England is better than 74 percent.

(2) Although the United States has a higher five-year survival rate, this discrepancy is attributed to our earlier detection and screening processes.
As the Journal of the National Cancer Institute wrote [PDF]: "similarity of mortality rates between the two populations supports the hypothesis that risk of fatal prostate cancer among British men does not differ from that among US white men. More intensive screening procedures, such as prostate-specific antigen testing, in the United States is the most likely explanation for the widening gap in incidence." In other words, we diagnose a lot of cancers that aren't lethal or are slow-moving enough to not require treatment. Saying, from that data, that we've got twice the survival rate is like saying we have a lower death rate from car crashes because we record more near-misses in the statistics.

(3) The average age of diagnosis for prostate cancer is 70. Therefore, you can expect that a whole hell of a lot of the people saved in the United States have Medicare (see "Socialized Medicine") to thank.

(4) The treatment used upon Rudy Giuliani was developed in a country with universal, single payer health care (see "Socialized Medicine").
[T]he technique used on Giuliani, prostate brachytherapy--using radioactive seeds--was pioneered in the modern era by a physician in Denmark, and brought to the US by one of his students.

You'd think a guy whose life was saved by bradytherapy would admit, however grudgingly, that European socialized medicine ain't all bad.

I'm disappointed, but not surprised, that this story hasn't received more attention. Instead, I just watched the Democratic debates on MSNBC, and they preferred to ask questions such as "What are you going to be for Halloween this year?" and "Do you believe in extraterrestrial life?"

Instead of covering this issue (where the top contender for a party's nomination lies about one of the biggest domestic issues), there are endless segments covering topics like "Is Hillary being evasive?" (see here, here) and "Is Hillary playing the gender card?" (see here, here).

There is something seriously wrong here.

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