4 ms·

It's not reasonable to use the rates from 30+ years ago because survival rates for all cancers have been sharply increasing for decades. You also need to consid

It's not reasonable to use the rates from 30+ years ago because survival rates for all cancers have been sharply increasing for decades. You also need to consider years of life lost if you're going to look at things economically, because you're formulating things as if somebody who died of cervical cancer never existed. Cervical cancer disproportionately affects older women, even moreso than other cancers. The average age of diagnosis is 50 [1] and so the years of lost life due to cervical cancer is both going to be extremely low and going to disproportionately be very late life years lost. Rates in U30 are already near zero with an extremely high survival rate for those that do get it. [1] - https://www.cancer.org/cancer/types/cervical-cancer/about/key-statistics.html https://www.cancer.org/cancer/types/cervical-cancer/about/ke...

pfdietz 4mo ago
So use the current rate, which is 2.2 per 100,000. The argument is basically the same. The cost/benefit ratio is so good that your quibbles don't change the conclusion.
- somenameforme 4mo ago
  Do you understand the problem I'm describing? You are saying that women who got cervical cancer essentially died at birth. You need to look at years of life lost. Cervical cancer has a low frequency, high survivability, and disproportionately effects women in later age. You also need to factor in the efficacy of the vaccines, which will not be 100%. The years of life lost/saved will end up most likely being in the days or weeks at most, and so the $12 million figure you pulled out of thin air, for a full lifetime, is highly inappropriate. This also generalizes to many medical issues. For instance, contrary to what most people think, early cancer screening achieves very little in terms of life extension. Prostate cancer screening, for example, adds about 37 days to one's life expectancy. [1] [1] - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2808648 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
  - pfdietz 4mo ago
    Let me shoot right back and ask if you understand what I was saying. Yes, I understood what you are saying. I was making a crude argument, but the crude argument showed benefit something like 18-36x the cost. The points you are making would reduce the benefit, but not by a factor anywhere close to 18.
    - somenameforme 4mo ago
      I think it certainly will. We can test it fairly easily by getting some real numbers. - Years of life lost per death = 17 [1] - Mortality rate = 2.2/100k - Life lost per person per year = ~3.3 hours (derived from 17 years * 2.2 cases / 100k people) - Total change in life expectancy if completely eliminated = ~3.3 hours/year for ~50 years = 1 week My argument is lowballing everything (or in other words working against me) since you used extreme ends for your argument, and I'm simply accepting them. I also used years of life lost data from 2000 when cancer survival rates have significantly improved since then, assumed 100% perfect efficacy and so on. It doesn't matter, because it's not even remotely close. From these data we can see that your argument implies implies that a person would be willing to pay about $20,000 (midpoint of your 18-36 = 27 x $750 cost of vaccine) for an increase of 7 days of life expectancy. That's nonsensical, by orders of magnitude, unless you're only polling multi millionaires to determine a statistical value of life. [1] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4167424/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4167424/
      - pfdietz 4mo ago
        That 2.2 per 100,000 is deaths PER YEAR, not PER LIFETIME. The vaccine is protecting against death each year over the person's life, not just in one year.
        somenameforme 4mo ago
        That is why I multiplied the change per year by 50, exactly as you did.

pfdietz 4mo ago

So use the current rate, which is 2.2 per 100,000. The argument is basically the same. The cost/benefit ratio is so good that your quibbles don't change the conclusion.

somenameforme 4mo ago
Do you understand the problem I'm describing? You are saying that women who got cervical cancer essentially died at birth. You need to look at years of life lost. Cervical cancer has a low frequency, high survivability, and disproportionately effects women in later age. You also need to factor in the efficacy of the vaccines, which will not be 100%. The years of life lost/saved will end up most likely being in the days or weeks at most, and so the $12 million figure you pulled out of thin air, for a full lifetime, is highly inappropriate. This also generalizes to many medical issues. For instance, contrary to what most people think, early cancer screening achieves very little in terms of life extension. Prostate cancer screening, for example, adds about 37 days to one's life expectancy. [1] [1] - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2808648 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
- pfdietz 4mo ago
  Let me shoot right back and ask if you understand what I was saying. Yes, I understood what you are saying. I was making a crude argument, but the crude argument showed benefit something like 18-36x the cost. The points you are making would reduce the benefit, but not by a factor anywhere close to 18.
  - somenameforme 4mo ago
    I think it certainly will. We can test it fairly easily by getting some real numbers. - Years of life lost per death = 17 [1] - Mortality rate = 2.2/100k - Life lost per person per year = ~3.3 hours (derived from 17 years * 2.2 cases / 100k people) - Total change in life expectancy if completely eliminated = ~3.3 hours/year for ~50 years = 1 week My argument is lowballing everything (or in other words working against me) since you used extreme ends for your argument, and I'm simply accepting them. I also used years of life lost data from 2000 when cancer survival rates have significantly improved since then, assumed 100% perfect efficacy and so on. It doesn't matter, because it's not even remotely close. From these data we can see that your argument implies implies that a person would be willing to pay about $20,000 (midpoint of your 18-36 = 27 x $750 cost of vaccine) for an increase of 7 days of life expectancy. That's nonsensical, by orders of magnitude, unless you're only polling multi millionaires to determine a statistical value of life. [1] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4167424/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4167424/
    - pfdietz 4mo ago
      That 2.2 per 100,000 is deaths PER YEAR, not PER LIFETIME. The vaccine is protecting against death each year over the person's life, not just in one year.
      - somenameforme 4mo ago
        That is why I multiplied the change per year by 50, exactly as you did.