A new study funded by a grant from the Cystic Fibrosis Foundation finds a disturbing difference in life expectancy between people with cystic fibrosis here in the U.S. and those in Canada. Specifically, Canadians with the disease live, on average, ten years longer than Americans with the condition.
The study was based on a comparison of 5,941 patients in the Canadian Cystic Fibrosis Registry and 45,448 patients in the U.S. Cystic Fibrosis Foundation Patient Registry. The investigators found the median age of survival in Canada from 2009-2013 was 50.9 years. The median age of survival for Americans during the same time period was 40.6 years.
That translates to a 34% lower adjusted risk of death for Canadians with CF.
Why the difference? The researchers found a few clues. Canadian patients with CF, for example, were more likely to have received a transplant, 10.3% vs. 6.5%. The fact that a high fat diet, which leads to better nutritional support for CF patients, was instituted for Canadians in the 1970s, vs. the 1980s for Americans, could also have come into play.
Insurance status made a difference too. While Americans with private health insurance had about the same survival rate as the Canadians in the study — all of whom benefited from universal health care coverage — Canadians had a 44% lower risk of death when compared to Americans on continuous Medicaid or Medicare and a 36% lower risk when compared to those on intermittent Medicaid or Medicare.
When compared to Americans with no health insurance, their risk was 77% lower.
“Differential access to transplantation, increased posttransplant survival, and differences in health care systems may, in part, explain the Canadian survival advantage,” write the authors.
The study was published online by the Annals of Internal Medicine on Mar. 14.