Giuliani's healthcare figure outdated

Republican presidential candidate Rudy Giuliani has made "socialized medicine" one of his favorite whipping boys on the campaign trail. But he is using a single, misleading, and outdated statistic to argue that the healthcare system in the United States is better than it is in the United Kingdom.

In a radio ad airing in New Hampshire, Giuliani says: "I had prostate cancer five, six years ago. My chance of surviving prostate cancer, and thank God I was cured of it, in the United States - 82 percent. My chances of surviving prostate cancer in England - only 44 percent, under socialized medicine."

Giuliani, who was diagnosed with cancer seven years ago, plucked the 10-year-old statistic from an article written by Dr. David Gratzer, an adviser to his campaign, in the 2007 summer issue of City Journal, an urban policy publication of the Manhattan Institute, a think tank much admired by the former New York City mayor.

ABC News, citing contradictory statistics from the British government, on Monday accused Giuliani of "fuzzy healthcare math," igniting a minitempest. The website of the UK's Office for National Statistics reports that the five-year survival rate for men with prostate cancer from 1999 to 2003 was 74.4 percent, up 3.6 percentage points for men diagnosed from 1998 to 2001, most likely because of "increasingly widespread use of prostate-specific antigen (PSA) testing."

Gratzer had relied on data from a 2000 report by the Commonwealth Fund, an independent foundation advocating healthcare reform. On Tuesday, Commonwealth said in a statement that Gratzer misrepresented the data, which did not measure five-year cancer survival rates and dates back to 1997.

A Giuliani spokeswoman told ABC News the campaign did not attempt to independently verify the information, which Giuliani cites in his stump speech.

Gratzer, in an interview yesterday, acknowledged that his assertion was based on old data that did not reflect commonly used five-year survival rates, but he said that more recent information shows Giuliani's basic assertion is true.

"There's a huge gap between what happens in the United States with cancer care and what happens in other countries," Gratzer said. "People are picking apart the numbers instead of looking at the trend."

Gratzer made his original US-UK prostate cancer comparison in a broader article titled "The Ugly Truth About Canadian Health Care." After the controversy erupted this week, Gratzer, a native of Canada, responded with a rebuttal titled "Malignant Rumor/On cancer survival rates, Rudy's right and his critics are wrong."

Since his article, he said, the journal Lancet Oncology has released a study showing the five-year American survival rate for men diagnosed with prostate cancer is 99 percent, compared to an average of 78 percent in Europe and 71 percent in Scotland and Wales, with incomplete data for England.

In his original article, Gratzer had stated: "The survival rate for prostate cancer is 81.2 percent here, yet 61.7 percent in France and down to 44.3 percent in England."

The data, however, did not measure survival rates, the Commonwealth Fund asserted. Rather, the figures were taken from a chart showing incidences - the number of men diagnosed in a single year - and deaths from prostate cancer per 100,000 men that same year, 1997, the fund said.

For the United States, the incidence was 136 per 100,000 and deaths were 26 per 100,000 males. For the UK, the incidence was much lower, 49 per 100,000, but the deaths were roughly the same, 28 per 100,000.

"Neither speaks to the length of survival, and that figure cannot be calculated using the others," the Commonwealth Fund said.