Backgrounds

Miserable Gains
The Fraud Of The Potential Years Of Life Lost

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ALSO SEE: SMOKING, LIFE EXPECTANCY AND HEALTH SURVEYS

How many times do we hear that, if we could eliminate cancer and cardiovascular disease (all caused by smoking, of course!), we would live so much longer? But have you ever asked yourself how much longer? Ask yourself now, then. The average life is about 74 years. If, by magic, cancer totally disappeared tomorrow regardless of its causes, by how much would life increase? Just for fun, we asked this question of several laypeople, and the answers they gave ranged between five and twenty years. In fact, no such spectacular increases would result. If all forms of cancer were to disappear tomorrow - together with an array of other important diseases such as cardiovascular ones (and even traffic accidents) - the average length of life would increase by 15-20 months. For cancer alone, 15 days at most. Surprised? Even if everything they say about smoking were true (i.e. that one cancer in three is due to smoking), therefore, the increase in average life after the elimination of  smoking would be quite tiny. Considering the persecutorial hysteria of the "prevention" campaigns and their enormous cost in terms of economics and liberty, we believe it is important that the public is given the tools to compare costs and real gains. Antismoking propagandists, who seem so enamoured with quantifications based on nothingness, do not seem to worry about educating the public about those realities because that could threaten their power - and that is the difference between information and propaganda.

Skip considerations and go to the data

SOME PRELIMINARY CONSIDERATIONS

  1. Some may object that the gains for smokers would be greater than for non-smokers, with the usual argument that smokers lose 5-6 years of life on average. But the loss for smokers is not due just to smoking but to a many other risks that occur more frequently in those who feel the need to smoke - and that often indicate a personality that is quite different from the personality of non-smokers - a personality with an inclination to take risks and either pay the price of those risks, and/or enjoy the benefits. So, if one could control for (that is, keep a mathematical account for) all those risks, the PYLL (potential years of life lost) due specifically to smoking would be much less than 5-6 years - although it is not possibile to establish that with any sort of precision due to the co-factors, which absolutely cannot be quantified.

  2. For Canada, the statistics apply to 1986, thus those are annual and not comprehensive data.

  3. The Italian data are a little "generous", but not out of range. That may be due to the method used to compute the data - a method that does not seem to be standard. At any rate, the approximate 2.5 years gain is due mainly to cardiovascular disease, and much less to cancer, as stated by the abstract itself.

  4. The evident discrepancies between the studies are due to the different computation methods, to different method and accuracy in collecting statistical data, to different population types, and to different distribution of the risk factors in different populations. What we can deduce is that the longevity gains are tiny even if we hypothesize the total elimination of the bulk of current diseases (note, for example, that the elimination of Alzheimer's disease it is not calculated. That disease is much more prevalent in non smokers, it is very expensive from a social point of view, as it renders the patient a vegetable - but it does not reduce life expectation).

In reality it is already very, very difficult to eliminate the bulk of the current diseases, and thus extremely difficult to reduce the PYLL. Moreover, the so-called "gains" obtained by the elimination of smoking, drinking, eating fats, etc. would simply turn into other diseases that are inevitabile in old age: dementia, diseases that force the patient into wheelchairs, Alzheimer's, Parkinson's, and so on. That is without taking into account the increased cost of pensions, and other public and private expenditures, often to keep alive those who are basically reduced to a vegetative condition. These costs are incurred in a time where the "right to health" contemplated in several constitutions, a "right" that is as politically correct as it is schizophrenic - inevitably transforms itself into unlimited access to new and extremely expensive technologies and "therapies" turned to extend life sometimes just for a few days or, in other cases for protracted periods - often with immense expenditures that are real (not statistical attributions). Those expenditures enormously weigh on the community that supports "public health" and its politicians. On the other hand, those politicians hide the inevitable collapse of a state health system that is often only apparently free by attributing more and more faults to lifestyles - in order to survive politically until the end of their mandates.

But the inexorable fact is that the human body inevitably ages, deteriorates, and finally seizes up and dies. Therefore, we may as well enjoy life with its pleasures while we can, without worrying too much about statistical "risks" that are too often not demonstrable. The elimination of those "risks", at best, gives us some extra months in exchange for apprehension, repression, prohibition, taxation and fear - and, sometime, even hatred.

We also have to accept that we inevitably die of something. Superficially and rationally, everybody agrees with that reality - but not emotionally, thanks in large measure to the idiotic propaganda pushed by  the health "authorities". People are subliminally led to believe that if they behave the way there are told, they don't have to worry about death. For that reason, dying has never been so much feared in cultures as it is today.

Finally, we have to accept that probably we have already reached the limit of average life that nature allows. We could still gain something by reducing infant mortality, which dramatically excessively affects the calculation of the average life of a population, but that has nothing to do with the reduction of cancer, cardiovascular diseases and so on in adults. Unless we find a way to genetically modify the longevity attributes of the population (with all the moral, ethical, social and economic consequences of such fundamental interference with nature), we must recognize that, as a society, we are getting to the maximum limit of the duration of human life.

On this issue, those who are interested can read Oshlansky's demographic study "Prospects for Human Longevity", which clarifies how difficult further gains for human longevity are to attain, how they would be at any rate tiny, and how close we actually already are to the limit of average longevity.

We invite those who want to further explore this interesting issue to download the scientific article "Macroeconomics of Disease Prevention in the United States" (PDF, 647K) of. Written in 1978 by Gio B. Gori (then director of the Division of Cancer Cause and Prevention and director of the program "Smoking and Health of the US National Cancer Institute), and Brian J. Richter, an economist at Enviro Controls, Inc. in Maryland. This article caused much trouble for the authors who, even 25 years ago, made the politically incorrect statement that "prevention" of those diseases that today are so often attributed to lifestyle would incur great social costs. Of course, the authors were accused of cynicism and not listened to by those in whose interest it was to delude people with the chimera of long life and "eternal" health. After 25 years, it is now possible to observe that their predictions are coming true. In spite of that, "public health" continues to deny the obvious, making empty promises and pointing its finger to lifestyles to distract us from the disastrous results of their "prevention" politics.

 

 

UNITED STATES

Small gains at national level - THE EFFECT OF A REDUCTION IN LEADING CAUSES OF DEATH: POTENTIAL GAINS IN LIFE EXPECTANCY - Tsai SP, Lee ES, Hardy RJ. - Am J Public Health. 1978 Oct;68(10):966-71. (If the link does not work, click here)

WHEN APPLIED TO THE ENTIRE POPULATION

Reduction by 30% of cardiovascular disease: 24 months
Reduction by 30% of melanomas: 8 months, 15 days
Reduction by 30% of traffic accidents: 2 months, 15 days

... AND WHEN THE ABOVE IS APPLIED TO THE 15 to 70 YEARS AGE RANGE:

Red. by 30% of cardiovascular disease: 5 months, 7 days
Reduction by 30% of melanomas: 3 months, 6 days
Reduction by 30% of traffic accidents: 1 month, 16 days

The potential gains in total expectation of life and in the working life ages among the United States population are examined when the three leading causes of death are totally or partially eliminated. The impressive gains theoretically achieved by total elimination do not hold up under the more realistic assumption of partial elimination or reduction. The number of years gained by a new-born child, with a 30 per cent reduction in major cardiovascular diseases would be 1.98 years, for malignant neoplasms 0.71 years, and for motor vehicle accidents 0.21 years. Application of the same reduction to the working ages, 15 to 70 years, results in a gain of 0.43, 0.26, and 0.14 years, respectively for the three leading causes of death. Even with a scientific break-through in combating these causes of death, it appears that future gains in life expectancies for the working ages will not be spectacular. The implication of the results in relation to the current debate on the national health care policy is noted.

PMID: 717606 [PubMed - indexed for MEDLINE]

   

Minimal gain with the elimination of cancer in the United States - PERSON-YEARS OF LIFE LOST DUE TO CANCER IN THE UNITED STATES, 1970 AND 1984 - Horm JW, Sondik EJ. - Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, MD 20892 - Am J Public Health. 1989 Nov;79(11):1490-3. (If the link does not work, click here)

The number of deaths due to cancer in the United States reached an all-time high of 453,450 deaths in 1984 and, due to the dynamics of population growth, will continue to increase if the risk of dying from cancer does not change. Between 1970 and 1984, the total Person-Years of Life Lost (PYLL), the sum of the difference between the actual age at death and the expected remaining lifetime for each person who died of cancer, increased for most cancer sites as well as for all sites combined. In 1984, 6,881,281 person-years of life were lost due to cancer deaths, up from 5,303,668 in 1970. The exceptions are those cancers for which there has been major progress in either prevention or treatment; e.g., stomach and cervix uteri (prevention) and testicular, Hodgkin's disease, leukemia, and childhood cancers (treatment). The Average Years of Life Lost (AYLL) per person dying from cancer in 1984 was generally less than in 1970. Overall, each person who died from cancer in 1984 died 15.2 years earlier than his/her life expectancy. The greatest loss was for those who died of childhood cancers (66.9 years earlier), followed by testicular cancer (35.8 years earlier). The least loss relative to the expectation of life was for those who died of prostate cancer. The 25,400 men who died from prostate cancer in 1984 died an average of nine years earlier than otherwise expected.

PMID: 2817158 [PubMed - indexed for MEDLINE]

   

Miserable gains in Texas - POTENTIAL GAINS IN LIFE EXPECTANCIES BY PARTIAL ELIMINATION OF LEADING CAUSES OF DEATH IN TEXAS - Tsai SP, Lee ES. - Tex Rep Biol Med. 1978;36:185-96. (If the link does not work, click here)

BETWEEN 15 AND 70 YEARS OF AGE

Elimination of 50% of cardiovascular disease: between 6 and 12 months
Elimination of 50% of cancer: 3 months
Elimination of 50% of traffic accidents: less than 3 months

Potential gains in life expectancies among Texas population by partial elimination of 3 major causes of death are examined on the basis of the available statistics from the population census and mortality statistics for 1970. Contrary to the popular anticipation of longer potential gains, the results are not particularly encouraging. The number of years of life that would be gained during the working ages by 50% elimination of major cardiovascular diseases is less than 1/2 of 1 year, about 1/4 of 1 year by 50% elimination of malignant neoplasms, and less than 1/4 of 1 year by 50% elimination of motor vehicle accidents. Even with a scientific breakthrough in combating those causes of death it appears that future gains in life expectancies for working ages will not be spectacular. The implications of the results in relation to the current debate on the national health policy are discussed.

PMID: 725791 [PubMed - indexed for MEDLINE] 

FINLAND

Z

If the days are divided by 365 and by the few (5 or 6 million) inhabitants of the country, that gains are miserable even in Finland - THE INCREASE IN WORKING YEARS DUE TO ELIMINATION OF CANCER AS A CAUSE OF DEATH - Hakulinen T, Teppo L. - Int J Cancer. 1976 Apr 15;17(4):429-35. (If the link does not work, click here)

FOR THE ENTIRE POPULATION

TOTAL ELIMINATION OF LUNG CANCER:

8,9 HOURS

TOTAL ELIMINATION OF STOMACH CANCER:

6,2 HOURS

TOTAL ELIMINATION OF LEUKAEMIA:

6,6 HOURS

TOTAL ELIMINATION OF BREATS CANCER:
4,6 HOURS
TOTAL ELIMINATION OF ALL FORMA OF CANCER, AND OF ALL "CANCER-RELATED RELATED RISKS"

2,38 DAYS

The relative significance of various forms of cancer in terms of causing death is analysed by estimation of the increase in person-years of working age (20-64 years) following elimination of the disease. Methods based upon the theory of competing risks are applied to the statistics on causes of death in Finland during the years 1966-70. It is estimated that if there were no lung cancer (the commonest type of cancer in both morbidity and mortality statistics in males in Finland) the annual deaths saved would yield 5,900 working years (both sexes combined)  Leukaemia and cancer of the stomach would be next in rank order, with figures of respectively 4,000 and 3,900 working years more. Female cancer with the highest incidence, that of the breast, would be characterized by 2,900 additional working years. The significance of types of cancer that affect young people is stressed in these calculations: leukaemia, brain tumours and lymphomas (both sexes combined) are 6th, 12th and 11th respectively in the statistics of cancer causes of death, but 2nd, 4th and 6th respectively in the list of additional working years to be gained by elimination of the disease. On the other hand, cancer of the prostate, 3rd in males according to the annual numbers of cancer deaths, would take the 15th position for the increase in working years in males. If no risk of cancer existed, the annual deaths saved would produce 36,000 working years, a figure exceeded only by those for cardiovascular diseases (55,000 working years) and accidents (51,000 working years). The results indicate that no practical differences exist between the results derived under the assumptions of various models for competing risks, but that the exclusion of competing risks may result in considerable degrees of bias in estimation if the population has a high general mortality.

PMID: 1279036 [PubMed - indexed for MEDLINE] 

CANADA

The gains for Canada? See above! - PREMATURE DEATHS IN CANADA: IMPACT, TRENDS AND OPPORTUNITIES FOR PREVENTION - Wigle DT, Mao Y, Semenciw R, McCann C, Davies JW. - Laboratory Centre for Disease Control, Health and Welfare Canada, Ottawa, Ontario - Can J Public Health. 1990 Sep-Oct;81(5):376-81. (If the link does not work, click here)

THE ENTIRE POPULATION

TOTAL ELIMINATION OF:
Coronary diseases, traffic accidents, violence, cardiovascular disease, lung cancer, perinatal conditions, as well as control of tobacco, hypertension, cholesterol, diabetes and alcohol abuse
14 DAYS, 6 HOURS

The impact, time trends and potential for prevention of premature deaths in Canada were assessed. There were almost 100,000 deaths before age 75 in Canada during 1986 resulting in over 1.7 million potential years of life lost (PYLL). The three leading broad disease categories responsible for PYLL were cancer, injuries/violence and cardiovascular disease. In both sexes, coronary heart disease, car accidents, lung cancer and perinatal conditions ranked in the top 5 specific diseases responsible for PYLL; breast cancer (females) and suicide (males) also ranked in the top 5 conditions. Over the period 1969 to 1986, death rates among persons less than age 75 increased for 3 conditions among females and 11 conditions among males. Lung cancer and brain cancer death rates increased in both sexes, chronic obstructive pulmonary disease death rates increased among females only and death rates for suicide and 8 types of cancer increased among males only. Over the same period, death rates declined for 37 discrete disease categories among both females and males including particularly large improvements for coronary heart disease, stroke, car accidents and perinatal conditions. An estimated 50,000 or over 50% of all premature deaths per year are preventable through control of smoking, hypertension, elevated serum cholesterol, diabetes and alcohol abuse. About 6,000 premature deaths are avoidable through improvements in medical care.

PMID: 2253155 [PubMed - indexed for MEDLINE]

 

In spite of the bias of this study ("An estimated 50,000 or over 50% of all premature deaths per year are preventable through control of smoking, etc"), a death is not avoided - at most, it is delayed - and "premature" refers to a theoretical average life span that does not apply to individuals. The theoretical gains in life span are absolutely pathetic - especially in consideration of what would be eliminated, and at what social cost. But the use of the word "avoid" appeals more effectively to emotions, with better results on the politicians that dispense public funds. Rational analysis is entirely bypassed.
What is the theoretical longevity gain for each Canadian, then? Even by pooling together all the "causes" and using the grand total: 1,170,000 years "lost" x the 365 days of the year = 427,050,000 days divided by 30 million Canadians = 14.24 days -- if we round it up!

 

ITALY

The gains in Italy are a little better (a bit more than two years); but to obtain that result cancer, AIDS and cardiovascula diseases -- and even traffic accidents! -- must be lumped together  - THE IMPACT OF THE MAJOR CAUSES OF DEATH ON LIFE EXPECTANCY IN ITALY - Conti S, Farchi G, Masocco M, Toccaceli V, Vichi M. - Laboratory of Epidemiology and Biostatistics, Istituto Superiore di Sanita, Roma, Italy. (If the link does not work, click here)

THE ENTIRE POPULATION

COMBINING THE REDUCTION OF CARDIOVASCULAR DISEASES, MALIGNANT TUMOURS, TRAFFIC ACCIDENTS AND AIDS MORTALITY
2, 27 years for men
2,16 years for women

BACKGROUND: This study aims to evaluate the contribution of the reduction in major cardiovascular diseases (CVD), malignant neoplasms (MN), accidents and AIDS mortality to the gains in life expectancy observed during the decade 1985-1994, as well as to calculate and compare the potential gains due to the partial or total elimination of these causes. METHODS: Mortality data from the Italian Mortality Data Base were analysed by the method of decomposition of changes in life expectancy and the partial multiple decrement life table technique. RESULTS: In Italy, considering the decade 1985-1994, the gain in life expectancy at birth was 2.27 years for men and 2.16 for women. The major contribution to this increase was the reduction in CVD mortality followed by fewer deaths from accidents and MN. Conversely, AIDS caused a loss in the length of life of adults. Major potential gains in life expectancy at birth could be obtained by the elimination or even partial reduction of CVD and MN mortality. When working life (15-64 years) is considered, the relative importance of the causes changes. The elimination of accidents and AIDS would result in increased life expectancy longer than that associated with a 50% reduction in CVD. CONCLUSIONS: The findings of this study provide useful information which could contribute to a more effective allocation of resources for research activity and public health programmes.

PMID: 10597990 [PubMed - indexed for MEDLINE]

 


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