Book of Odds
Page 20
The odds a Mexican American woman 20 or older has heart failure 1 in 76.9
The odds a man 20–39 has heart failure 1 in 500
The odds a woman 20–39 has heart failure 1 in 333
The odds a man 40–59 has heart failure 1 in 52.6
The odds a woman 40–59 has heart failure 1 in 125
The odds a man 60–79 has heart failure 1 in 11.1
The odds a woman 60–79 has heart failure 1 in 18.5
The odds a man 80 or older has heart failure 1 in 8.7
The odds a woman 80 or older has heart failure 1 in 8.5
SOURCE: Book of Odds estimate based on National Health and Nutrition Examination Survey data in RL Veronique, AS Go, DM Lloyd-Jones, RJ Adams, JD Berry, et al., on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, “Heart Disease and Stroke Statistics—2011 Update: A Report from the American Heart Association,” Circulation 123, 2011: e18–e209.
Some Procedures Are Much Riskier Than Others
The odds a person will die during mitral valve surgery: 1 in 16.7
The odds a person will die during aortic valve surgery: 1 in 32.3
The odds a person will die during coronary artery bypass surgery: 1 in 52.6
SOURCE: Book of Odds estimate based on National Health and Nutrition Examination Survey 2008 data, http://www.cdc.gov/nchs/nhanes.htm.
Lifesavers
The odds a person who has out-of-hospital cardiac arrest will receive CPR from a bystander: 1 in 3.1
The odds a person who has out-of-hospital cardiac arrest will receive defibrillation from a bystander: 1 in 47.6
The odds a person who has out-of-hospital cardiac arrest will be discharged alive: 1 in 14.3
SOURCE: Book of Odds estimates based on data in RL Veronique, AS Go, DM Lloyd-Jones, RJ Adams, JD Berry, et al., on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, “Heart Disease and Stroke Statistics—2011 Update: A Report from the American Heart Association,” Circulation 123, 2011: e18–e209.
Have 1 in 10,000 People Misplaced Their Hearts?
A small percentage of people—in the United States, about 0.01%, or 1 in 10,000—has a congenital condition known as “situs inversus” (SI), in which his or her internal organs are a mirror image of the typical organ layout: thus, the liver and gallbladder lie on the left, and the stomach, spleen, and heart on the right. Because SI presents few symptoms, many people do not discover their organs are inverted until later in life, often after a medical procedure.
Despite its orientation, the heart itself is generally unaffected. People with situs inversus are only slightly more at risk for heart disease. It does come with a predisposition to sinus infections and chest colds, which manifest themselves in approximately 20% of people with SI. This symptom, known as Kartagener syndrome, occurs when the body’s cilia (the tiny, moving hairs that flush foreign objects out of the respiratory tract) are immobile from birth. Because half of people with Kartagener syndrome have situs inversus, too, a sort of ongoing chicken-and-egg debate has arisen over which causes which.
Organ reversion does not typically affect a person’s lifespan, but—prior to being diagnosed—he or she is at risk for some disquieting mix-ups. For example, a seemingly benign pain in the lower left of the abdomen can end up being appendicitis; a tingling right arm, a heart attack. Often, people who know they have SI wear bracelets to indicate their dextrocardia, so that in a medical emergency doctors know where their heart lies.
SOURCES: DN Kennedy, KM O’Craven, BS Ticho, AM Goldstein, N Makris, JW Henson, “Structural and Functional Brain Asymmetries in Human Situs Inversus Totalis,” Neurology 53(6), October 12, 1999: 1260–1265. Office of Rare Disease Research, National Institutes of Health, Situs Inversus, Genetic and Rare Disease Information Center, http://rarediseases.info.nih.gov/GARD/Condition/4883/Situs_inversus.aspx.
GENDER WARS
The odds a woman 45 or older who survives her first heart attack will die within one year of the event are 1 in 3.8 vs. 1 in 5.3 for a man.
SOURCE: Book of Odds estimate based on data in RL Veronique, AS Go, DM Lloyd-Jones, RJ Adams, JD Berry, et al., on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, “Heart Disease and Stroke Statistics—2011 Update: A Report from the American Heart Association,” Circulation 123, 2011: e18–e209.
Heart Attacks Come in Packs
Of the 935,000 heart attacks in a year, 35% or 325,000 are not first-time events.
The odds a woman 45 or older will have another heart attack or fatal coronary heart disease within five years are 1 in 4.5. Men 45–64 face better odds: 1 in 6.7. For a man 65 or older, however, the odds are 1 in 4.5.
SOURCE: Book of Odds estimates based on pooled data from the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, and Framingham Heart Study published in “Heart Disease and Stroke Statistics—2011 Update: A Report from the American Heart Association,” Circulation 123, 2011: e18–e209.
More Than We Can Bear
You really can die from a broken heart.
A decade ago, Japanese cardiologists noticed something odd about several victims of cardiac arrest. A typical heart attack results from deterioration of the heart and arteries, cholesterol buildup, embolism, or some other factor. But these patients showed little or no sign of cardiovascular disease. EKG imaging revealed an unusual problem: a partial malfunction of the left ventricle caused the tip of that heart chamber to bulge instead of contracting. On the EKG, the ventricle resembled, to the Japanese doctors’ eyes, a tako-tsubo—an octopus trap. Hence the syndrome’s first name: takotsubo cardiomyopathy, or as it is more commonly called, “Broken Heart Syndrome.”
Broken Heart Syndrome most often occurs in the face of overwhelming shock or loss. A heart reacts adversely to the release of stress hormones and stops pumping correctly—Dr. Scott Sharkey of the Minneapolis Heart Institute refers to it as a “concussion” of the heart.
The odds a person will experience Broken Heart Syndrome in a year are 1 in 25,010. Those are slightly lower than the odds a person in the United States will be murdered in a year (1 in 24,605). The odds a person will die of it in a year are only 1 in 2,345,000. With proper treatment, almost all patients make a full recovery.
The odds a person will survive Broken Heart Syndrome are 1 in 1.01. Only a heartbreaking few will die from it.
SOURCES: D Derrick, “The ‘Broken Heart Syndrome’: Understanding Takotsubo Cardiomyopathy,” Clinical Care Nurse 29, February 2009: 49–57. Book of Odds estimates based on data in US Census Bureau, Population Division, “Table 1. Annual Estimates of the Population for the United States, Regions, States, and Puerto Rico: April 1, 2010 to July 1, 2011” (NST-EST2011-01), December 2011. US Department of Justice, Federal Bureau of Investigation, Crime in the United States, 2011, September 2012.
Selected Stroke Odds by Age, Race, and Gender
SOURCE: Book of Odds estimates based on National Health and Nutrition Examination Survey data in RL Veronique, AS Go, DM Lloyd-Jones, RJ Adams, JD Berry, et al., on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, “Heart Disease and Stroke Statistics—2011 Update: A Report from the American Heart Association,” Circulation 123, 2011: e18–e209.
Cancer
Racial Disparities: Lifetime Cancer Risk
The odds a person will ever be diagnosed with cancer:
White 1 in 2.4
Black 1 in 2.6
Hispanic 1 in 2.7
Asian or Pacific Islander 1 in 2.8
American Indian or Native Alaskan 1 in 3.5
SOURCE: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012.
GENDER WARS
The odds a woman will ever be diagnosed with cancer are 1 in 2.6 vs. 1 in 2.2 for a man.
SOURCE: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012.
Lifetime Odds of Cancer (most likely to least likely)
SOURCE: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, er al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012.
As the Smoke Drifts
Part, but not all, of the changing likelihood of lung cancer can be traced back to smoking habits. The increasing odds a woman will die of lung cancer in a year can be explained by the increase in smoking by women in the fifites and sixties, for example . . .
Here is an overview: In 1965, the prevalence of smoking among men was 52% versus 34% for women. By 1979, the prevalence had dropped to 38% for men and 30% for women, and in 1998, 26% for men and 22% for women. By 2011 the smoking prevalence dropped to 22% for men and 17% for women, so lung cancer death rates will continue to decline going in the future.
The odds a woman/man will die of lung cancer in a year (by year):
SOURCES: Office on Smoking and Health, Women and Smoking: A Report of the Surgeon General, Atlanta, GA: Centers for Disease Control and Prevention, March 2001, http://www.ncbi.nlm.nih.gov/books/NBK44303/ Office on Smoking and Health, “Trends in Current Cigarette Smoking Among High School Students and Adults, United States, 1965–2009,” Centers for Disease Control and Prevention, http://www.cdc.gov/tobacco/osh/index.htm. Centers for Disease Control and Prevention/National Center for Health Statistics, “Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2011,” Vital and Health Statistics Report 10(256), December 2012. N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012.
GENDER WARS
But What if One Never Smoked?
The odds a woman 40–79 who never smoked will be diagnosed with lung cancer in a year are 1 in 6,579 vs. 1 in 8,929 for a man 40–79.
SOURCE: US Department of Health and Human Services, SEER Cancer Statistics Review, 1975–2007.
Breast Cancer
The odds are 1 in 8.1 a woman will receive a diagnosis of breast cancer in her lifetime, about the odds a person lives in California, the most populous state. For men the odds are 1 in 769, about the same odds a Major League Baseball game will be a no-hitter.
Young women are less likely to get the disease. For those under age 50, the odds of being diagnosed with breast cancer in a year are only 1 in 6,959; for women older than 50, the odds shoot up to 1 in 1,037. Peak incidence occurs between the ages of 75 and 79.
Thanks to the widespread adoption of regular mammography screenings, more and more women are being diagnosed with breast cancer before it’s too late. In 1975, the odds a woman would be diagnosed with breast cancer in a year were 1 in 952 compared to 1 in 802 in 2007, an increase of 16%. Early detection has lowered the odds a woman will die of the disease in a year from 1 in 3,185 in 1975 to 1 in 4,348 in 2005–2009.
Depending on the type of breast cancer and what stage it was when discovered, treatment can involve chemotherapy, radiation therapy, surgery, or a combination of the three. With early detection and proper treatment, the outlook is good and getting better. During the period of 1985 to 1989, the odds a living woman had survived five years or longer after diagnosis were 1 in 1.2; for those diagnosed in 2004, those odds had increased 9% to 1 in 1.1. And as of 2009, the odds of having survived for at least twenty years were 1 in 1.5—the fifth-best survival odds among leading cancers affecting women.
SOURCE: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012.
Breast Biopsy Results by Age
The odds a woman who has a biopsy as a result of a mammogram will be diagnosed with invasive breast cancer:
Age 40–49 1 in 7
Age 50–59 1 in 4
Age 60–69 1 in 3
Age 70–79 1 in 2.3
Age 80–89 1 in 1.8
The odds a woman who has a biopsy as a result of a mammogram will have benign findings:
Age 40–49 1 in 1.2
Age 50–59 1 in 1.5
Age 60–69 1 in 1.7
Age 70–79 1 in 2.1
Age 80–89 1 in 2.7
Result of a Suspicious Lesion on a Mammogram by Age:
SOURCE: DL Weaver, RD Rosenberg, WE Barlow, L Ichikawa, PA Carney, K Kerlikowske, et al., “Cancer: Pathologic Findings from the Breast Cancer Surveillance Consortium,” Cancer 106, 2006: 732–742.
Breast Cancer Treatment Odds
The odds a woman 20 or older diagnosed with invasive breast cancer at a stage less than IIIA:
will receive multiagent chemotherapy treatment 1 in 1.4
will have breast-conserving surgery with radiation 1 in 2.4
will have a mastectomy 1 in 2.9
will have breast-conserving surgery without radiation 1 in 4.7
will not require surgery 1 in 56.7
SOURCE: National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Cancer Trends Progress Report—2009/2010 Update, April 2010, http://progressreport.cancer.gov.
Prostate and Breast Cancer
Increase in Incidence or Result of Increased/New Testing?
Both prostate cancer and breast cancer exhibited an apparent increase in incidence in the early 1990s. In those years, the PSA (prostate-specific antigen) test became widely used as part of routine medical exams for men. In 1987, 29% of women reported having a mammogram in the past two years and that increased to 70% by 2000. Thus the increase in incidence of prostate cancer and breast cancer in the 1990s was earlier detection of those cancers due to changes in the number of women receiving mammograms and to the introduction of the PSA test. Incidence rates of both are returning to 1980s levels.
SOURCES: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012. American Cancer Society, Breast Cancer Facts and Figures, 2011–2012. Atlanta, GA: American Cancer Society.
A Frightening Diagnosis
Every year, more than 42,000 people in the United States are diagnosed with pancreatic cancer. As shown previously men and women have a similar lifetime risk (about 1 in 70). It is the eighth most commonly diagnosed cancer. Based on the latest available data, the odds a person diagnosed with pancreatic cancer will survive at least one year are only 1 in 3.3.
Pancreatic cancer has been notoriously hard to treat because of an outer coating that surrounds the cancerous cells, protecting them from being destroyed by traditional chemotherapy. Groundbreaking new treatments target this tough layer, enabling a second drug to reach the cancer cells, and there is real hope that survival odds may increase.
SOURCE: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/,
based on November 2011 SEER data submission, posted to the SEER website, April 2012.
The Odds of Beating Colorectal Cancer
1 in 51.5 people will die from colorectal cancer.
The odds of surviving:
1 year: 1 in 1.2 5 years: 1 in 1.5 10 years: 1 in 1.7
The best way to prevent colorectal cancer is to have routine colonoscopies.
The odds a routine colonoscopy will find:
diverticulosis: 1 in 2.2
a polyp: 1 in 2.7
hemorrhoids: 1 in 2.9
nothing abnormal: 1 in 4.8
multiple polyps: 1 in 13.9
suspected malignant tumor: 1 in 15.6
a tumor: 1 in 250
SOURCES: N Howlader, AM Noone, M Krapcho, N Neyman, R Aminou, SF Altekruse, et al., eds., SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER website, April 2012. JE Everhart, ed., The Burden of Digestive Diseases in the United States (NIH Publication No. 09-6443). Washington, DC: Government Printing Office, 2008.
Gender-Specific Cancers
Prostate Cancer
The surge in prostate cancer detection shown on the previous page is largely attributable to the development of the prostate-specific antigen blood tests for men. The odds of receiving a diagnosis of prostate cancer in a given year also rise with advancing age: for a male 65 or older the odds are 1 in 126, compared to 1 in 1,577 for males younger than 65. For reasons that are not fully understood, both the incidence and the death rate are roughly double in black men compared to white men.
Luckily, prostate cancer is widely considered to be one of the most treatable forms of cancer, especially when it is detected early. The odds a man will die of prostate cancer in a year declined from 1 in 3,229 in 1975 to 1 in 4,548 in 2009—a reduction of 28%.