Decade lifespan difference in Americans and Canadians with cystic fibrosis

A new study has emerged looking into life expectancy of those with cystic fibrosis, funded by the US Cystic Fibrosis Foundation, and carried out by researchers at St. Michael’s Hospital in Toronto. The research found a huge difference in lifespan between citizens of the US and Canada, with an average life expectancy in the US of 40.6 years compared with 50.9 years in Canada.

The difference of over ten years came from comparing 45,456 patients’ data in the US registry and 5,941 patients’ data in Canadian registry. The trend for Canada’s care to be of high-quality extended even when judged against patients in the US who had private healthcare, with life expectancy comparable to those on state funding healthcare in Canada. The situation becomes far worse for those who were relying on Medicare or Medicaid, or those with no insurance at all, with 36% to 77% higher risk of death than ordinary citizens in Canada.

Cystic fibrosis is a condition caused by a genetic mutation that caused the thick production of mucus, which can build up within the lungs causing infections. As the rate of infections increase, scarring of the tissue can lead to a reduced ability to breathe and further health complications.

The research did not attempt to find the reasons for this but several conjectures were offered. The main difference identified was the diet between Canada’s patients and the US patients, with Canada having instigated a high-fat, high-calorie diet in the 1970s. The diet has since begun to be followed around the world, and directly correlated with an increase likelihood of survival and lifespan.

"Achieving a better understanding of the drivers behind differences in survival rates is critical to our mission to improve and extend the lives of people with cystic fibrosis," said Dr. Bruce Marshall, lead study investigator for the Cystic Fibrosis Foundation and senior vice-president of clinical affairs for the organization. "As a result of this study we will be conducting further research to better understand the role of nutrition and insurance status - and are encouraged that the findings reinforce the central goal of our lung transplant initiative, a comprehensive effort to improve transplant outcomes for people with CF in the United States."

As Marshall states, the next step for research will be to discover precisely what factors are involved in the differences in lifespan and finding effective action to improve the US statistics. The US has moved to implement the high-calorie diet and so statistics may improve in future studies, as those benefiting from the diet progress in age. It does raise the issue, again, that the healthcare system in the US, despite being the most costly in the world, does not provide the best statistics on patient care.

Ben Hargreaves