This is not a recap of the tiresome reality series. Rather, it is a look at the stark differences in cancer survival rates between the United States and the Philippines. Although it is a mere demographic slice, it serves to show how important access to health care can be. And, tucked into this data, there is some evidence that the cost of treatments can make a difference — most likely because it affects access to care.
Acknowledging that comparisons of cancer survival data between the developed world and developing countries are very rare, researchers sifted through 9 years’ worth of information to see what they would find. Their report can be found online in the British Journal of Cancer in a study titled “Cancer survival discrepancies in developed and developing countries: comparisons between the Philippines and the United States.”
Specialists from Germany, Manila, and the United States used information on cancer compiled by the National Cancer Institutes. The NCI makes all these numbers available online, if you want to spend an afternoon in front of your screen. The survey is known by its acronym, SEER, which stands for Surveillance, Epidemiology, and End Results. It’s a rich resource.
In Manila, records were collected by the Philippine Cancer Society-Manila Cancer Registry and the Department of Health-Rizal Cancer Registry. And, although epidemiology may seem like a dry field, burdened by numbers and statistical analysis, that was not the case here. Working in the Philippines, the researchers also had to comb through death certificates at local registries and match them with records from a database. In some cases, they had to make personal visits to a patient’s last known address in order to find out whether that person was dead or alive.
To see how ethnicity factored in, the researchers made sure they surveyed Filipino-Americans living in the United States, who had access to the same health care system as white Americans. Their reach was broad: in all, they looked at outcomes for more than 600,000 people.
The researchers found that 5-year survival rates were much higher for Filipino-Americans than for those in the Philippines — 20 percent to 30 percent higher for some cancers (colorectal, breast and cervix) and 32 percent for leukemia. The survival gap in the Philippines was the largest for leukemia, the scientists said, because the treatments were the most expensive.
“The differences between the Filipino resident population and Filipino-Americans suggest continued inadequacy of access to or utilization of diagnostic and therapeutic procedures in the Philippines,” Dr. Hermann Brenner, an epidemiologist in Heidelberg, Germany, and his colleagues write. “Although diagnostic and treatment facilities are available, access for a majority of cancer patients is still a problem.”