Lies, damned lies and NHS cancer statistics

David Cameron and Andrew Lansley\’s repeated criticisms of the NHS\’s record on cancer have been contradicted by new research that shows the health service to be an international leader in tackling the disease.

The findings challenge the government\’s claims that NHS failings on cancer contribute to 5,000-10,000 unnecessary cancer deaths a year, which ministers have used as a key reason for pushing through their radical shakeup of the service.

No, the figures do not show that at all.

While cancer deaths fell everywhere, England and Wales saw the biggest drop in mortality among males aged 15-74 – down 31%. While six countries saw falls of at least 20%, England and Wales – which in 1979-81 had the third highest rate with 4,156 deaths per million men – improved the most, achieving the fifth lowest rate among the 10 countries by 2004-06 with 2,869 deaths per million. Among men aged 55-64 and 65-74, who are more likely to get cancer, mortality dropped by 35% and 28%.

What they show is that the NHS used to be shite at cancer and now it\’s only middle ranking.

For measuring the rate of improvement is not the same as measuring the absolute rate. Think of cars for a moment: we can measure the rate of acceleration of a Trabbie going from 5-20 mph and this is faster than the acceleration of a Ferrari going from 65-70 mph (well, it might not be actually but you get the idea). But the Ferrari is still going at a faster absolute rate than the Trabbie, isn\’t it?

So it is with the NHS and cancer: results are getting better faster than some other places. But they\’re still worse than many other places.

And the NHS was the most efficient of the 10 countries at reducing cancer mortality ratios once the proportions of GDP spent on healthcare were compared, the study found.

Trivially true. Curing the first 10% of cancer cases that are curable is cheap. Curing the last 10% of cancer cases that are curable is going to be expensive. Because, you know, this marginal cost thing? So a system which spends less to cure less cancer is going to be more efficient in its use of money to cure cases of cancer. Because it\’s only curing the easy cases.

No, I don\’t know whether it\’s the paper itself which makes these false claims or the way the G has written it up. But the headline claim simply isn\’t what those numbers are showing. Even though the NHS has been getting better at curing cancer it\’s still bad at doing so.

11 comments on “Lies, damned lies and NHS cancer statistics

  1. There are lots of claims around to the effect of “A has got a better five year cancer survival rate than B”. One way to achieve this is for A to diagnose cancers earlier, and to diagnose proportionately more slow-growing cancers, and then – without necessarily extending the life of a single patient – boast about the fact that more of its people survive for 5 years after diagnosis.

  2. @Prog It’s not enough to say that the figures are dismal: they cite the 5-year survival rate but, as I have just explained, that might or might not be informative. I don’t know and it’s possible that the authors don’t know either. If you have extra information that might resolve this ambiguity, why don’t you tell us what it is?

  3. I keep on saying that the law of diminishing returns is one of the most difficult economic concepts to grasp (and one of the more important ones)

  4. I don’t have any stats, but that article links to a BBC piece that comments on the late diagnosis of osteosarcoma in this country compared to some of the European countries they compare to.

  5. OK – let’s say that the way G wants to define success is the best definition. For now.

    And according to the underlying report, the best country both in absolute terms and in terms of rate of progress is…wait for it…the US.

    I wonder if the G would maintain that this is to be the preferred definition of success?

  6. I keep on saying that the law of diminishing returns is one of the most difficult economic concepts to grasp…

    I came across it first in GCSE chemistry, but can’t for the life of me remember why. It made sense then, and still does.

  7. Even in primary school we understood the value of the ‘Most Improved Pupil’ cup when it always went to some thickie who had decided to try working for a week.

  8. Mr. Potarto

    And yet we continously hear arguments about how terrible it is that the Chinese or Vietnamese economies are growing faster than the European ones…

  9. The reason that the UK has a poor past record for cancer treatment is nothing to do with the NHS, but everything to do with the British medical establishment.

    Historically, British doctors organised themselves by body parts – an Ear Nose and Throat man, a Dermatologist, a Nephrologist for the kidneys, and so on, rather than by medical condition. So in the UK cancer treatment was complicated by turf wars; cancer of the throat was treated by an ENT specialist, cancer in the kidneys by a nephrologist, etc, and individual doctors were deeply reluctant to admit ignorance in their own specialist areas, and to pass patients on to the colleagues who might know a bit more about the condition.

    For various reasons that didn’t happen in the USA, where cancer treatment became an early and powerful specialisation in its own right. That’s why, as Gary points out, America is still the best place to be treated.

    My point here is that David Cameron’s and Andrew Lansley’s criticisms of the NHS are misplaced. But presumably it would be politically impossible to blame the real culprits.

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