Rudy Giuliani Relies on Innumeracy

Specifically, The Commonwealth Fund report features a chart showing that, in 1997, the incidence of prostate cancer in the U.S. was 136 per 100,000 males and the mortality rate (death rate) was 26 per 100,000 males. By comparison, in the U.K. the prostate cancer incidence was 49 per 100,000 and the death rate was 28 deaths per 100,000. (The prostate cancer incidence rate—which is the number of men diagnosed with the disease in a given year—in the U.S. is thought to be higher because prostate cancer screening is much more common in this country.)

The Giuliani campaign dishonestly uses the above information to calculate survival rates. It is my belief that he is relying on the fact that the average american thinks that math is hard and so won't look behind the numbers. What I do for a living relies on me explaining complicated numbers in a clear and concise manner. What Giuliani is doing here is simply misusing the numbers and, to my mind, willfully lying.

I know that I shouldn't be shocked that this asshole lies about something but this is such a basic thing and such an easily checked thing that I have to hope that every single male in the media will call him on it.

Then there is this recent article from the cbc

So what would you do if you found out that several of the top prostate cancer doctors think the disease is being over-diagnosed and over-treated?

Take Toronto medical oncologist Dr. Ian Tannock. "I absolutely refuse to be screened. I don’t know my PSA [prostate-specific antigen level]. I think it’s overdone and men are having surgery they don’t need. Even the most gung-ho urologist would admit a lot of men are having prostatectomies [prostate removal] that weren’t going to die of it. The real challenge is picking up the men who would benefit."

His thoughts are echoed by one of the top prostate cancer researchers in the United States, Dr. James Talcott of Massachusetts General Hospital.

"You’re certainly more likely to be harmed than helped by being screened and diagnosed," Dr. Talcott says. "With immediate treatment you pay the price right away in terms of sexual dysfunction and other problems. There’s no question the prostate cancer mortality rate would be zero if we took out the prostate of every 25-year-old man, but at what price?"

And from the National Cancer Institute

A complicating feature of any analysis of survival after treatment of prostate cancer and comparison of the various treatment strategies is the evidence of increasing diagnosis of nonlethal tumors as diagnostic methods have changed over time. Nonrandomized comparisons of treatments may therefore be confounded not only by patient-selection factors but also by time trends. For example, a population-based study in Sweden showed that from 1960 to the late 1980s, before the use of prostate-specific antigen (PSA) for screening purposes, long-term relative survival rates after the diagnosis of prostate cancer improved substantially as more sensitive methods of diagnosis were introduced. This occurred despite the use of watchful waiting or palliative hormonal treatment as the most common treatment strategies for localized prostate cancer during the entire era (<150 radical prostatectomies per year were performed in Sweden during the late 1980s). The investigators estimated that if all cancers diagnosed between 1960 and 1964 were of the lethal variety, then at least 33% of cancers diagnosed between 1980 and 1984 were of the nonlethal variety.[3][Level of evidence: 3iB] With the advent of PSA screening, the ability to diagnose nonlethal prostate cancers may increase further.

What that means is that when you use PSA to screen you are picking up more cancers that would NEVER KILL YOU ANYWAY. There is an old saying that you are more likely to die with Prostate Cancer than of it. This is something to bear in mind when someone trots out the "ooooo scary cancer" BS about this particular disease. All cancers are not created equal and the diagnosis of Prostate Cancer is not a death sentence either here or in any other country in the world.

The press release from the COmmonwealth Fund can be found here