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Cervical Cancer Just Got Much Deadlier -- Because Scientists Fixed a Math Error (arstechnica.com)
An anonymous reader quotes a report from Ars Technica: Cervical cancer is 77 percent more deadly for black women and 44 percent more deadly for white women than previously thought, researchers report today in the journal Cancer. But the lethal boosts aren't from more women actually dying than before -- they're from scientists correcting their own calculation error. In the past, their estimates didn't account for women who had undergone hysterectomies -- which almost always removes the cervix, and with it the risk of getting cervical cancer. We don't include men in our calculation because they are not at risk for cervical cancer and by the same measure, we shouldn't include women who don't have a cervix," Anne F. Rositch, the study's lead author and an epidemiologist at Johns Hopkins told The New York Times. For the study, the researchers looked at national cervical cancer mortality data collected between 2000 to 2012. They also looked into national survey data on the prevalence of hysterectomies. Then, they used those figures to adjust the number of women at risk of dying of cervical cancer. The researchers found that black women have a mortality rate of 10.1 per 100,000. For white women, the rate is 4.7 per 100,000. Past estimates had those rates at 5.7 and 3.2, respectively. The new death rate for black women in the US is on par with that of developing countries. Though the new study wasn't designed to address racial disparities, experts speculate that the large difference reflects unequal access to preventative medicine and quality healthcare.
Seems like an obvious error from a statistical analysis standpoint. Makes me wonder how much critical medical research has obvious errors like this.
See? I always told everyone math give you cancer! Now I finally have a proof.
You're a male? OMG, you're so racist!!
It seems to me both are true and useful. I would even go so far as to say the original number is more useful.
1 in X women die from cervical cancer. (old number)
Of women who did not have a hysterectomy (prior to cancer), 1 in Y die from cervical cancer. (new number)
Both are true. How might mortality rates be used? One important use is comparisons for policy making decisions:
10 in X women die from heart disease, 1 in X die from cervical cancer. Therefore, we should invest more prevention efforts toward heart disease.
Or:
X% of women die from alcoholism, Y% from cervical cancer. Therefore, we should spend the most money researching cures for ______ ?
For these policy, questions, we want to know how many people are affected. Period. It's not a useful comparison to say "of people who drink, X die from alcoholism, while of people who have a uterus, Y die from cervical cancer". Those numbers don't give us any useful comparison with which to make decisions. The useful numbers for decision making are "how many people could be helped by addressing this issue?"
It sounds like they just divided women into two sub-groups, one of which has a zero risk of getting cervical cancer.
The overall risk of cancer for women is still the same.
Depending on what you are using the statistic for (e.g. assessing your own risk of getting cervical cancer, large-scale targeted prevention efforts, allocating government health-care funding based on overall population, etc.), you may find the new set of statistics more useful than the old one, or vice-versa.
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
Cervical cancer didn't become deadlier, we've just become slightly better informed.
Ask your doctor about getting an HPV vaccination.
Quattuor res in hoc mundo sanctae sunt: libri, liberi, libertas et liberalitas.
Even more annoyingly, hint at issues with carbon-14 dating and you're a global warming denier, discuss climategate and you're a creationist.
The racial disparity they're talking about in this case is that white women are more likely to get a hysterectomy after they get cervical cancer than black women are. They aren't talking about the overall higher death rate among black women, which could be affected by vitamin D.
Cancer might not be caused by lack of quality healthcare, but dying of cancer certainly can be. i.e. People who have access to quality cancer treatments are more likely to survive than people who don't.
I don't care if it's 90,000 hectares. That lake was not my doing.
Article is paywalled so I can't read their actual data. If R is the rate at which women die of cervical cancer, n is the number of women who die of cervical cancer, N is the population of women, and h is the fraction who have had hysterectomies.
R_initial = n / N
R_adjusted = n / (N - h*N) = (n / N) * (1 / (1-h))
R_adjusted / R_initial = 1 / (1- h)
(1-h) = 1 / (R_adjusted / R_initial)
h = 1 - 1/(R_adjusted / R_initial)
For black women, R_adjusted / R_initial = 1.77, so
h = 1 - 1/1.77 = 0.435
43.5% of black women have had hysterectomies.
For white women, R_adjusted / R_initial = 1.44, so
h = 1 - 1/1.44 = 0.306
30.6% of white women have had hysterectomies.
According to this site over 1/3 of women over age 60 have had hysterectomies. Which seems to agree with the above calculated rates. I had no idea hysterectomies were that prevalent.
"Science-based beliefs are the new bible. One is either a Darwinist [...] There is no longer room for discussion or dissent."
About species evolution by means of natural selection? No, certainly there's no longer room for discussion or dissent. Just like it's the case about thermodynamics or, say, special relativity. No, ignoramus douchebags' rants don't count.
This new number was created by explicitly removing women that do have quality healthcare by removing women from the study that had hysterectomies, a form of quality healthcare when cervical cancer is involved. What is left are women that do not have quality healthcare.
You do realize that a woman NOT having a hysterectomy does NOT mean they don't have access to quality healthcare, right?
I browse on +1 so AC's need not respond, I won't see it.
Or aren't idiots:
...as if cancer is caused by either of those. Political alert!
Cervical cancer is deadly in the final stages when symptoms begin appear that force people to seek medical care. If it's caught early through routine exams it has an exponentially higher survival rate.
I browse on +1 so AC's need not respond, I won't see it.
Ask your doctor about getting an HPV vaccination.
Unless he's a 30 year old virgin it's probably too late for him to get....wait... this is /.
Yes, go get the HPV vaccination.
I browse on +1 so AC's need not respond, I won't see it.
experts speculate that the large difference reflects unequal access to preventative medicine and quality healthcare.
Which "experts"? Why dismiss all the other cultural and genetic possibilities?
If it is about "access", why do poor whites have better life expectancy, and why are Hispanics so healthy and long lived in the US?
Cervical cancer is virtually always (according to cancer.org) caused by an HPV infection. Effective prevention as part of healthcare is how you combat STDs like that, so yes, it seems reasonable to expect that poor healthcare will lead to increased cervical cancer rates.
Make no mistake, HPV vaccinations are good for men to get too - even though they don't have cervices because the virus has been linked to other cancers - including throat and tongue cancer. Even if you argue those links are not really definitive yet, getting the vaccine prevents the risk of becoming a carrier and acting like a cervical cancer typhoid-Mary (now watch as the MRA's start demanding men not get the HPV vaccine because men shouldn't be expected to NOT kill women they have sex with).
Unicode killed the ASCII-art *
It's a classification error.
what planet are you on?
You're confusing antivaxxers with MRAs.
Cancer might not be caused by lack of quality healthcare,
Actually, in this case, lack of quality healthcare DOES rise the incidence of cancer:
Like several other types of cancer (e.g.: like colon cancer ; unlike pancreatic cancer), it's possible with a routine test to detect cellular anomalies long before those degenerate into an actual cervical cancer (the same way you can notice polyps on a scopy long before an actual cancer).
But for those early detection to be done, the woman needs to be able to afford going to a gynaecologist for said test to be done.
Otherwise she'll eventually get actual cervical cancer.
Also, cervical cancer is one of the few cancers where there is a well known and documented infectious cause - human papilloma virus - that accounts for a significant chunk of cervical cancer.
But again, for prevention to work, the woman needs to be able to afford going to a doctor who'll administer an HPV vaccine.
(or - less optimally - to gynaecologists who'll at least detect the HPV infection and do closer monitoring)
Otherwise the poor woman will catch HPV, which will go unnoticed, and eventually she's at high risk being one of those who caught a cervical cancer as a consequence of HPV infection.
(Disclaimer : I am a doctor, Jim ! ...but population health isn't my speciality).
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
This is completely wrong.
Science-based beliefs are the new bible. One is either a Darwinist global warmist or religious scum taking money from Big Oil. There is no longer room for discussion or dissent. Just hint at possible issues with carbon-14 dating and you're branded a creationist. Discuss the climategate and you're automatically a global warming denier.
It's just like the switch between Republicans and Democrats over the last century. Nowadays it's easier to have discussions with pro-lifes or intelligent designers than with "learned" people.
Maybe for you it is easier. Why have a discussion with someone who refuses to acknowledge facts and sticks their head in the dung pile? Seriously, the time for discussion is past on some portions of these topics, e.g., Are we pumping stored CO2 into the atmosphere? Yes. Does CO2 have the ability to raise temperatures? Yes. Is the world warming? Yes. Anything that refutes those statements requires backing scientific evidence of a degree that would indicate matter/energy can be destroyed, as the science behind those facts is about as solid as you can get. I'm not sure what you want to argue about there, or why. Maybe it goes against intelligent design or a pro-life stance?
What's your issue with Carbon-14 dating? That it's limited to 50K years and that it is based on statistical sampling? Don't complain about the acknowledged error margins unless you can come up with something better. We'll all be all ears should you do so. At this time it is one of the few tools in the basket for this specific task.
The cesspool just got a check and balance.
The study isn't looking at women who had cancer and DIDN'T get hysterectomies. It's looking at incidence of the disease...NEW DIAGNOSIS. To calculate incidence you take the population at risk for the disease and see how many develop it per year.
(XXX cases) / (People who can possibly get it) = Incidence
The study made the observation that:
(XXX cases) / (All women) = Incidence A ---> (XXX cases) / (All women WHO HAVEN'T HAD HYSTERECTOMY) = Incidence B
Because the denominator is smaller in the 2nd case and the numerator is unchanged, Incidence B > Incidence A
Everyone who is suggesting that this study makes some conclusion about how cervical cancer is treated is completely missing the point of the study. It's not about how it's treated, it's about how common it is. Hence why the title about "Deadlier" is completely and utterly irrelevant to the study itself.
Just because you have to buy private for-profit insurance doesn't mean that a for-profit hospital will set up in your town. The "solution" is to cut costs by eliminating the profit motive in insurance and carers. Just that should eliminate 30-50% of healthcare costs (10%-15% profit, and the 10%-20% of a company dedicated to increasing profit but unrelated to services, times two middlemen). Having basic insurance doesn't guarantee access to health care. That was proposed, and shot down by the Republicans who would rather the poor just crawl under a rock and die.
Learn to love Alaska
Nope. MRAs are anti-HPV-vax, not necessarily anti-vaxxers. MRAs see no problem with their sex acts killing women. The women shouldn't have been promiscuous.
Learn to love Alaska