Cystic Fibrosis Patients In Canada Outlive US Counterparts
- Author: Joanne Flowers Mar 15, 2017,
Mar 15, 2017, 13:59
In fact, Canadians with cystic fibrosis live 10 years longer than Americans.
Since the early 1970s, both nations have maintained cystic fibrosis patient data registries. However, as revealed by the study, Canadians with cystic fibrosis were told beginning in the 1970s to follow a high-fat diet, but in the USA, this diet was not recommended until the 1980s. It was at that time that the gap in the survival rate began widening even further.
But the differences aren't just about math - they're real, the researchers soon discovered.
Even after adjusting for patient characteristics, such as age and severity of disease, the risk for death among people with cystic fibrosis was 34 percent lower in Canada than in the United States.
Survival has increased in both countries, but Canada began to see greater improvements than the US starting in 1995, with a more dramatic increase in the survival rate in Canada noted in 2005.
Comparative data analysis of patient records spanning between 1990 and 2013 determined both countries had had success with increasing survival for patients over time, with Canada continuously reporting more substantial improvements.
"The reasons for the survival gap is definitely multifactorial and not based on one factor alone", Stephenson wrote in an email, adding that the study was not created to determine any direct causes.
"Achieving a better understanding of the drivers behind differences in survival rates is critical to our mission to improve and extend the lives of people with cystic fibrosis", said Dr. Bruce Marshall, lead study investigator for the Cystic Fibrosis Foundation and senior vice-president of clinical affairs for the organization.
In an accompanying editorial, Dr. Patrick Flume of the Medical University of SC and Donald VanDevanter of Case Western Reserve University applauded the study, saying researchers now must find and implement solutions to bridge the survival gap, "which seems to be based on fundamental differences in the two nations' health-care systems". The impact of each of these factors remains unknown, however.
Research also showed a higher percentage of lung transplants in Canadian cystic fibrosis patients, combined with an increased mortality rate in US patients that didn't qualify for a transplant.
In 2005, when the United States began using a lung allocation score to prioritize people on the transplant waiting list, the survival gap also increased dramatically, the authors noted. The most common reason for death in cystic fibrosis is due to progressive lung disease. While the study was not created to note the cause of this difference in patient lifespan, the researchers suggested it may be due to differences between Canadian and American diets, medical insurance, and the use of transplant treatments. This score, blood type and distances between the lung donor and patient all factor into who gets a lung first.
Half of the Canadians survived past age 51, whereas half of the USA patients had died by age 41.
Differences in survival between US and Canadian patients varied according to USA patients' insurance status (Canadians have universal, publicly funded health care coverage).
Continuous Medicaid or Medicare coverage recipients, however, were documented to have a 44 percent higher risk of early death than Canadian patients, whereas for people benefiting from intermittent Medicaid or Medicare coverage this risk was reportedly increased by 36 percent.
US patients with private health insurance had similar survival rates to their Canadian counterparts.
"These statistics are sobering", said Dr. Anne Stephenson of St. Michael's Hospital in Toronto, who led the study. "The impact of US health insurance/health care policy and survival in U.S".
Canadians living with cystic fibrosis-a serious lung condition-have higher survival rates than Americans, according to latest study findings.
More than 30,000 Americans, and 70,000 people around the world, are living with cystic fibrosis, caused by inheriting a defective gene from each parent.
One of them was Canada's adoption in the 1970s of a high-fat, high-calorie diet that resulted in patients being better nourished, said Stephenson, director of the Canadian Cystic Fibrosis Registry. Marshall said the CF Foundation is raising concerns with transplant regulators about whether nuances in that system give other lung diseases more priority.