Cancer Survival

In comparing U.S. and Canadian survival rates for lung cancer, colon cancer, Hodgkin's disease, and breast cancer, GAO found that breast cancer patients lived longer after diagnosis in the United States than in Canada. The outcomes were mixed for the other types of cancer studied. Nine to 10 years after cancer was detected, the survival rates for U.S. patients were indistinguishable from (in the cases of cases of colon cancer and Hodgkin's disease) or lower (in the case of lung cancer) than survival rates in Canada. One possible interpretation of these findings is that quality of care for breast cancer patients is better in the United States than in Canada and that for the three other cancers it is about the same. Other interpretations focus on differences in detection.

GAO found that: (1) the United States and Ontario share similar patterns of survival for lung cancer, colon cancer, Hodgkin's disease, and breast cancer; (2) the U.S. survival rate for breast cancer is consistently higher than the corresponding rate for Ontario; (3) although the U.S. survival rates for colon and lung cancer start higher than the corresponding rates for Ontario, the initial U.S. advantage for colon cancer is lost after 6 years and for lung cancer after 3 years; (4) there are no statistically significant differences in rates for Hodgkin's disease; (5) the initial U.S. advantage in colon cancer survival is retained for patients under 60, who constitute about 20 percent of all colon cancer patients; and (6) in three of the age-specific groups, Ontario's survival rates for patients with Hodgkin's disease may actually be slightly higher than the U.S. rate, as a result of age distribution differences.