Cystic Fibrosis Outcomes Better In Canada Than The US: Study


A progressive genetic disease, cystic fibrosis manifests through chronic lung infections that gradually compromise the patients's breathing ability.

There is no cure available for the condition, but research is continually developing new medication to improve quality of life and increase life expectancy.

A new study, however, shows Canadians suffering from cystic fibrosis have more chances to a better prognosis than patients in the United States.

The findings, featured March 14 in the journal Annals of Internal Medicine, reveal Canadians living with this affliction survive, on average, 10 years longer than their American counterparts.

Researchers funded by the U.S. Cystic Fibrosis Foundation analyzed patient data registries published annually by the foundation, and compared them with reports by Cystic Fibrosis Canada.

Results pointed to a significant difference in the median life expectancy between the two registries and set out to discover what gives Canadian patients a better outcome than those being treated for cystic fibrosis in the United States.

3 Major Factors Differentiate Patient Outcome

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. Data involving 45,456 U.S. patients and 5,941 Canadian patients revealed life expectancy for the latter began to grow exponentially in 1995, surging considerably in 2005.

Results indicated a strong "survival gap" during the later years of the study as well. Research showed the median survival age recorded in Canada between 2009 and 2013 was 50.9 years, whereas U.S. patient registries documented an average life expectancy of only 40.6 years.

The 10-year difference in patient outcomes was particularly determined by better survival rates in male cases.

Dr. Anne Stephenson, study lead author and respirologist at the Adult Cystic Fibrosis Center of St. Michael's Hospital in Toronto, believes several factors may influence the discrepancy between the two countries.

"We hypothesize that three factors may be playing a role in the survival gap: lung transplantation; differences in the two health care systems; the differential approach to nutrition in the 1970s that started first in Canada," she said in a statement.

Better Lung Transplant Rates, Health Insurance And High-Fat Diet

In 2005, the United States implemented a lung allocation score to prioritize patients waiting for a transplant according to disease severity and estimated success chances. Study authors suggest, however, that this individualized score, created by the Organ Procurement and Transplantation Network, may in fact reduce chances of receiving a lung transplant for cystic fibrosis patients.

This could explain why the survival gap between Canada and the United States became more apparent since 2005. Research also showed a higher percentage of lung transplants in Canadian cystic fibrosis patients, combined with an increased mortality rate in U.S. patients that didn't qualify for a transplant.

Regarding health care system disparities, patient data analysis revealed private insurance beneficiaries reported similar survival percentages as Canadians receiving the 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. Lastly, early death risk among American patients without health insurance was found to be 77 percent larger.

Another major difference between the two countries involved the targeted diet for cystic fibrosis sufferers. Stephenson explains this condition affects the digestive system's capacity to absorb fat, which is why a high-fat diet is now mandatory in standard patient care worldwide.

According to the study, Canadian health care providers began implementing this dietary approach 10 years earlier than American physicians, accounting for Canada's rising survival rates in 1995.

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