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.


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This entry was written by Kathi, posted on Monday, April 25, 2011 at 08:04 pm, filed under Diagnosis, Recurrence, Screening, Health & Healthcare, Life & Mortality, Metastastatic Breast Cancer, Nitty Gritty, Research, Survivorship and tagged , , , , , . Bookmark the permalink . Post a comment below or leave a trackback: Trackback URL.

10 Responses to “Math Lessons — The Human Cost of Cancer”

  1. Kathi,
    Thank you for doing this. I couldn’t agree with you more that public perception is out of whack with the facts.

  2. Kathi, Thanks for researching this. I agree with Andrew, things seem to be a bit out of whack.

  3. Kathi: Very well said and very true. I hear this on a daily basis from our clients that “it’s not all about the pink”. Everyone’s cancer is important to them and your statistics bear out the facts that there are other types of cancer out there that need mention so the public perception jives with the facts.

  4. As my fiance is batteling terminal pancreatic-metastatic cancer, I can tell you – the Gov’t tends to ignore this killer because of it’s very high mortality rate – it is a crying shame and the numbers will only continue to go up. I work with the Pancreatic Cancer Action Network now – pancan.org – We figure it is our only hope to make changes with this devistating killer. You look at the #’s you posted – Pancreatic Cancer is almost always a death sentence – the only cancer that has shown zero survavability improvements in the last 40 years! Good info – thanks for putting it out there! Visit my blog: edandmk.blogspot.com

  5. Kathi,

    Thank you for such a comprehensive, to-the-point posting. Cancer is traumatic, no matter which type one is unlucky to get. It doesn’t really discriminate.

  6. “Duplication abounds, and marketing appeal holds more sway than need.” Well said, Kathi. Has the sexiness of the breast cancer cause siphoned money away not only from metastatic breast cancer but also the other cancers that are more likely to kill? This is a thorny question indeed, and another uncomfortable one. We need to think calmly and deeply about it.

  7. Thanks, everyone.

    Andrew, thanks for visiting the blog. I’m so glad Pat put me onto your work at The Web Savvy Patient. I think a lot of us can say that without the resources of the web, we would have been up a creek without an oar. That was certainly true for me when I was diagnosed with cancer, especially when I began dealing with the aftermath of treatment. I could write an entire post just on that subject!

    MaryKaye, I’ve had too many patients over the years, patients in the prime of their lives, who’ve been lost to pancreatic cancer. Patrick Swayze exemplified how unfair and deadly this particular cancer is. I don’t know much about what research is being done on it, but it just seems to me that there should be some kind of early screening test for it, to catch it before it has wreaked its havoc. I will definitely visit your site.

    Jane, there appears to be almost no logic or cohesiveness out there when you look at the totality of research, fundraising, awareness or services for cancer patients. It’s maddening, especially because there are really solid efforts out there, brilliant organizations that have worked hard to develop comprehensive guidelines for helping cancer patients get what we need over the entire span of our diagnosis, treatment and after-treatment. The Centers for Disease Control and the Institute of Medicine have both done excellent work on this & have published their findings in online, downloadable form. You can find links at my post, Not All Better — A Survivorship Toolbox.

    The realm of breast cancer ‘awareness’ certainly typifies what is right and wrong with cancer services, treatment and public education. As many of you know and write about, there is so much incomplete, misleading and flat-out erroneous information being put out there by often well-meaning awareness organizations, with no apparent effort on the part of some of them to educate themselves about what is really needed or wanted by those of us who’ve had breast cancer. Perhaps the only good thing about all this is that there are enough of us to identify some of these problems and hopefully steer the ship onto a course that makes more sense for us and for all cancer patients.

    Personally, I think one of the inadequately-addressed issues that comes up over and over again for all kinds of cancer is the financial impact it has on us as individuals. When I think of all the money people spend on pink knick-knacks, all the time and resources spent on redundant and ineffective public education programs, it makes me nuts. I’m still in a financial hole because of cancer, I’m still too tired to work full-time, never mind being able to address the myriad issues of home and personal maintenance that come up every day. And I’m one of the “lucky” ones who can at least work enough to keep a roof over my head, who has health insurance, who had “early” cancer. So far, I haven’t found an organization that I can call to get free help for the things I really need. But, hey, I can buy enough cause-related marketing crap to redecorate my entire house in pink. Oy…

  8. This is what happens when you make profits more important than people.

    You must scream, call, write and VOTE and when they don’t listen CALL THEM ON IT!

  9. You’re good. You’re very good. -shelli

  10. Thanks, Shel. Nice to be appreciated.

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