Health Care Quality: How Does the United States Compare with Other Countries on Cancer Survival and Access to Bone Marrow Transplantation?

GAO discussed the quality of health care in the United States, focusing on: (1) a comparison of survival rates for cancer patients in the United States and Ontario; and (2) the availability and appropriateness of allogeneic bone marrow transplantation in the treatment of leukemia. GAO noted that: (1) cancer patients in the United States and Ontario share strikingly similar patterns of survival for different types of cancer; (2) similarities in survival exist for patients of different age, sex, and year of diagnosis; (3) breast cancer patients in the United States experience a slightly but consistently higher level of survival than Ontario's breast cancer patients; (4) U.S. patients with Hodgkin's disease, colon cancer, and lung cancer demonstrate higher survival rates than their counterparts from Ontario, but U.S. survival rates decrease between 1 and 6 years after diagnosis; (5) until the effect on survival of possible variations in detection practices can be determined, the implications of any differences in measured survival for quality of care will remain unclear; (6) U.S. cancer patients are less likely to receive bone marrow transplants than patients in 6 other countries; (7) U.S. cancer patients are among those least likely to receive their transplants at the most appropriate point in the progression of their disease; and (8) in all likelihood, many U.S. cancer patients have received bone marrow transplants when the procedure was not necessary.