Cancer Survival Depends on Where You Live

By Steven Reinberg
18 july 2008-- Your odds of surviving cancer depend on which country you live in. And, in the United States, it also depends on whether you're black or white, a new study finds.
Economic differences among countries, access to health care, and the availability of cancer treatments feed the disparities in survival, the report said.
"There is a very wide global range in the odds of survival after a cancer diagnosis," said lead researcher Michel Coleman, a professor of epidemiology at the London School of Hygiene and Tropical Medicine in Great Britain. "Some of the range is understandable on the basis of the relative wealth of these countries," he added.
The study also confirms the disparity in cancer survival among blacks and whites in the United States, Coleman said. "The differences are large across the U.S.A., and even in different metropolitan areas," he said.
Coleman believes the differences among countries -- and within regions of countries -- is directly related to access to health care. "This is not a question of the competence of doctors in any particular country," he said. "This is an issue of the overall effectiveness of health services."
The report was published in the July 17 online edition of The Lancet Oncology.
For the study, called the CONCORD study, Coleman's team collected data on 1.9 million cancer patients in 31 countries. Using cancer registries from each country, the researchers compared the five-year survival rates for breast, colon, rectal and prostate cancer.
The United States has the highest rates of survival for breast and prostate cancers, while Japan has the highest survival rates for colon and rectal cancers among men. France has the highest survival rates for colon and rectal cancer among women, the report found.
In addition, Canada and Australia also have very high survival rates for most cancers. The lowest rate of survival among both men and women was seen in Algeria.
In the United States, the lowest survival rates are in New York City, except for rectal cancer in women, where Wyoming scores worse. The best survival rate for cancer in the United States is in Hawaii, the researchers found.
Idaho also has a high survival rate for rectal cancer, and Seattle has the highest survival rate for prostate cancer.
But, there's a big disparity in cancer survival rates between whites and blacks in the United States, and it favors whites. The differences range from 7 percent for prostate cancer to 14 percent for breast cancer. This disparity is most likely due to differences in the stage of cancer when it is diagnosed, the researchers said.
There's also a significant difference in cancer survival rates between the United States and Europe, with survival rates 10 percent and 34 percent higher in the United States for breast cancer and prostate cancer, respectively, the study found.
In Europe, France has the highest survival rate for rectal and colon cancers. Sweden has the highest survival rate for breast cancer, and Austria has the highest survival rate for prostate cancer.
The worst performing European countries are Poland and Slovakia.
Coleman said he hopes that political leaders will use the findings to provide better cancer diagnosis and treatment.
"Where the system is either slow in diagnosis, has too few doctors, has very few radiotherapy machines or in some countries, none, you would expect differences in outcome, and that's what these overall survival estimates are helping us provide," he said.
Dr. Elmer Huerta, president of the American Cancer Society's National Volunteer Board of Directors, said the study provides evidence for what has long been suspected -- namely, that where you live plays a role in cancer survival.
"The world needs to wake up to the fact that cancer is the second leading cause of death all over the place," he said. "Policymakers don't really put the weight to cancer care."
Huerta thinks more emphasis needs to be placed on the prevention, diagnosis and treatment of cancer.
"The world needs to smell the coffee and realize cancer can be prevented, and cancer can be cured if found early," he said.