Rudy's Misleading Advertising about his Prostate Cancer

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Rudy's been taking some bad press for an ad he's running in New Hampshire about his prostate cancer.

Eugene Washington at the Washington Post writes:

Even Rudy Giuliani would acknowledge that he can be prickly. Now, it seems, the tough-talking former mayor is growing estranged from empirical fact.

I'm referring to his presidential campaign's recent radio ad in New Hampshire, in which Giuliani speaks of his personal experience with prostate cancer and then cites an ear-grabbing statistic: "My chances of surviving prostate cancer -- and thank God I was cured of it -- in the United States: 82 percent. My chances of surviving prostate cancer in England: only 44 percent under socialized medicine."

Hold it, you mean I'd be nearly twice as likely to die of prostate cancer in Liverpool as in Los Angeles? Twice as likely to succumb in Oxfordshire as in Ohio? Amazing. Also, not remotely true.

Ezra Klein at the Guardina Unlimited writes:

His statistics are, as the maligned Brits would say, bollocks. In America, mortality from prostate cancer is 15.8 per 100,000 males. In Britain, it's 17.8 per 100,000. What America does have is a radically more aggressive screening program, which doesn't seem to lower mortality much, but radically increases our diagnostic rate.

Kevin Drum comments:

The only reason the U.S. has a higher survival rate is because we diagnose way more prostate cancer than Britain in the first place. In other words, the difference probably isn't that we're any better at prostate cancer surgery than the Brits, but that we aggressively screen for even mild cases of prostate cancer that probably aren't life-threatening in the first place - and then, unsurprisingly, we go on to survive all these non-threatening cancers regardless of treatment.

I'm no fan of socialized medicine. It's full of problems. I am, however, a fan of understanding facts--not making them up or selecting from studies that are not the most reliable on the topic.

It appears he at least got the trend correct: mortality in the U.S. is slightly better than in Britain. But only slightly. Treatment is much the same. We diagnose more and earlier in the U.S.

Rudy's claims appear to originate from a single study: performed by physician, David Gratzer. The data is 7 years old. Britain has improved since then. And, the data are subject to misrepresentation, as evidenced by Rudy's ad. Back to the Washington Post story:

Okay, the math: Gratzer writes that his figures come from seven-year-old data from the Organization for Economic Cooperation and Development on the numbers of men in various countries who are diagnosed with prostate cancer and, of those diagnosed, how many die from the disease. The latest official figures show a much smaller gap: Of men diagnosed with prostate cancer, about 98 percent survive five years in the United States vs. about 74 percent in Britain.

But even that is misleading, because -- as even Gratzer acknowledges -- a much higher percentage of American men than Britons are diagnosed with prostate cancer in the first place. The reason Americans are more likely to be diagnosed is that we are screened and tested much more often than our British counterparts. Doctors here are much more likely to diagnose, say, a slow-growing tumor in an elderly patient who will die of something else before the prostate cancer progresses to a serious state.

That's why the more relevant comparison, experts say, is mortality rates -- which are about equal. For the record, I prefer our system of screening and testing; if I'm going to be hit by a freight train, I want to see it coming.

Again, I like the way we do things. Let's just present our findings accurately (note to Rudy).

If this Gratzer study's findings are not the defining, most accurate, most reliable data (How could they be? They're 7 years old!) relative to prostate cancer, why use them in an ad?

Picking statistics to fit your desires is all too common. In the long run, though, you get discredited. Not a good approach.