Giuliani’s Prostate Cancer Figure Is Disputed

By JULIE BOSMAN
In a radio advertisement playing in New Hampshire and in speeches along the campaign trail, Rudolph W. Giuliani has cited statistics to cut at the heart of his Democratic rivals’ health care proposals, which he has derided as European-style “socialist” plans that will lower the standard of care in the United States.
“I had prostate cancer five, six years ago,” Mr. Giuliani, a Republican presidential candidate, said in a speech that has been turned into the radio commercial. “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.”
Mr. Giuliani’s Democratic rivals would argue that they are not advocating government-run health care in their plans to extend coverage to the uninsured. But, beyond that, the 44 percent figure that Mr. Giuliani has been citing is in dispute.
The Office for National Statistics in Britain says the five-year survival rate from prostate cancer there is 74.4 percent. And doctors also say it is unfair to compare prostate cancer statistics in Britain with those in the United States because in the United States the cancer is more likely to be diagnosed in its early stages.
“Certainly, if you intensively screen for prostate cancer, you will find early disease,” said Dr. Ian M. Thompson, chairman of the department of urology at the University of Texas at San Antonio. “And simply because you find it earlier, you will always have longer survival after the disease is diagnosed.”
Maria Comella, a spokeswoman for Mr. Giuliani, said yesterday that the 44 percent figure came from an article in City Journal, a publication of the Manhattan Institute, a conservative research organization.
“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,” Ms. Comella said in an e-mail message.
That article, titled “The Ugly Truth About Canadian Health Care,” was written by Dr. David Gratzer, a senior fellow at the Manhattan Institute and an adviser to the Giuliani campaign.
In an interview, Dr. Gratzer said the statistic came from the Commonwealth Fund, a nonprofit group in New York specializing in health care policy issues, but he acknowledged that it was seven years old and “crude.”
But the Commonwealth Fund said yesterday that Dr. Gratzer had misused its research by calculating a five-year survival rate based on data on prostate cancer incidence and mortality rates in the United States and Britain.
“Five-year survival rates cannot be calculated from incidence and mortality rates, as any good epidemiologist knows,” the group said in a statement.
Dr. Gratzer dismissed the Commonwealth Fund’s statement, saying the group had “an ideological bias.” Asked if Mr. Giuliani would continue to repeat the statistic, and if the advertisement would continue to run, Ms. Comella responded by e-mail: “Yes. We will.”