Tuesday, April 26, 2011

Math Lessons -- The Human Cost of Cancer

I was thinking about the veritable explosion of breast cancer awareness and fundraising groups in the last several years.  If you didn’t know any better, you might think it was the only kind of cancer out there anymore.  Or you might think it had the highest rate of incidence in the population or the highest number of deaths or the highest rate of mortality.  And you’d be wrong.

In the U.S., breast cancer does occur more often in women than any other kind of cancer, but the kind that kills more women than any other is lung cancer.  In fact, lung cancer still kills more Americans than any other kind of cancer, with an estimated 157,300 deaths in 2010 alone, according to the National Cancer Institute.  Pretty deadly.  And yet, in terms of sheer mortality, or the chance that a given kind of cancer will kill you, pancreatic cancer tops the field with a hideous 85% mortality rate last year, according to the NCI.   Should more money go to the types of cancer that kill the most people or the types that are most likely to kill you?

I decided to perform a little experiment.  I Googled different types of cancer-specific organizations in the U.S. and noted the number of hits.  Lung cancer organizations in the U.S. did produce the most hits, at 9,230,000.   Next came breast cancer orgs, at 9 million, followed by prostate at 8,170,000, and leukemia at 5,290,000.  Melanoma orgs followed at just over 2 million, and pancreatic cancer at just under 2 million.  Colon cancer was a close runner-up at 1,770,000, trailed by kidney cancer orgs at 1,230,000, bladder at 1,210,000, and lagging behind were thyroid cancer orgs at 737,000, non-Hodgkins lymphoma at 437,000, and endometrial/uterine cancer at just 339,000 hits.
Why did I pick these forms of cancer?  Again, according to the NCI, these represent the twelve most common forms of cancer in the U.S. in 2010.  The list includes cancers that occurred in at least 40,000 new patients last year.  I decided to tweak the data and produced the following table as a PDF.

How do fundraisers and researchers and legislators and awareness groups decide which types of cancer to focus on?  And how can you tell if they’re delivering what they promise?  Charity Watchdog.org, the site for the American Institute of Philanthropy, provides a list of their top-rated charities, which are those that they graded A through B+ according to their criteria.  ”Groups included on the Top-Rated list generally spend 75% or more of their budgets on programs, spend $25 or less to raise $100 in public support, do not hold excessive assets in reserve, and receive “open-book” status for disclosure of basic financial information and documents to AIP.”  If you scroll down the page, you’ll find that only twelve of the thousands of cancer charities in the U.S. make the grade.  According to their August 2007 article, called “Cancer Charities Need Dose of Organizational Chemotherapy”, the process that drives the formation of philanthropic groups appears to be influenced more by culture than math.  Duplication abounds, and marketing appeal holds more sway than need.

“Two-thirds as many women died of colorectal cancer as those that died of breast cancer in 2003. Yet based on a search of Guidestar’s database of charity tax forms, 1,326 charities mention being involved with breast cancer and only 56 charities mention work in colon cancer and 11 in rectal cancer. Why are there only 5% as many groups addressing colorectal cancer as breast cancer victims? A likely reason is that colorectal cancer, also called bowel cancer, is not as attractive from a fundraising or marketing perspective…”
Even statistics compiled by reliable sources can differ.  The Centers for Disease Control maintain an online calculator which generates totals for cancer incidence and mortality in the U.S. by gender, type and race, up to 2007, the most recent year included in their database.  Here are some tables I generated there, which show the rates of cancer per 100,000 persons:

A few things to note: endometrial & uterine cancer is called “corpus & uterus” on these tables.  You may also notice that leukemia, pancreatic cancer and thyroid cancer are not listed at all, as they are on the NCI table, but ovarian cancer is.   These next tables break down cancer incidence by sex:

And these are just the most prevalent cancers.  There are approximately thirty difference organs and systems listed in the NCI database in which cancer can occur, and hundreds of different types.   What if you are diagnosed with one of the less common forms of cancer, like brain cancer or multiple myeloma or testicular cancer?  If you end up getting some rare form of cancer, are you more likely to die?  Incidence, as we can see above, is not necessarily proportional to mortality.  On the other hand, if you are in need of education and support, do you have to have a more “popular” type of cancer to get the help you need?  If your cancer is not “common,” will you be able to get accurately diagnosed in time to get effective treatment?

Whatever you make of all this data, it certainly puts a different face on the relative merits of ribbon colors, glib marketing phrases, and awareness campaigns.  The prevalence of all the diseases known as cancer seems to defy them all.

Cancer, the equal opportunity rainbow.

1 comment:

  1. "If you haven't any charity in your heart you have the worst kind of heart trouble" to cure it help people, let's unite for one good cause, be a volunteer"save lives"! mawaddainternationalaid