19 May—In 1907, not too long before he moved to Redding from New York City, Mark Twain wrote, “Figures beguile me, particularly when I have the arranging of them myself; in which case the remark attributed to Disraeli would often apply with justice and force: ‘There are three kinds of lies: lies, damned lies, and statistics.’” The attribution to Disraeli is erroneous. As to the sentiment . . .

In all events, for better of worse, the world revolves around statistics. Including the medical world.

Statistics (the singular noun)—the collection, analysis, and interpretation of numerical data—comes to mind today because of yesterday’s announcement of Joe Biden’s prostate cancer. It’s not clear whether Joe has been tested for prostate cancer as part of his regular physical exams. But although he’s been receiving the very best medical care available to mere men for most of his life, he may not have been tested or examined for prostate cancer since he turned 70.

That’s because statistics (the plural noun)—the actual data collected and analyzed—have been interpreted to rule out prostate cancer screening, including simple and inexpensive prostate-specific antigen (PSA) tests, for men over 70. The rationale is that the potential benefits of early detection and treatment are supposed to be outweighed by potential harms and risks.

And that’s because statistics show that most prostate cancers tend to be slow-growing and that men over 70 naturally have shorter life expectancies than younger men, thus increasing the likelihood of their dying from other causes than prostate cancer.

Of course, any risks associated with early detection of prostate cancer are purely mental and emotional. Who wants to be told he has a cancer of any sort? Treatment by radiation, chemotherapy, hormone therapy, or surgery, on the other hand, does come with risks. And the risks should certainly be balanced with the benefits, the ultimate decision being made by the man with the cancer, not a statistician.

But if the superannuated man doesn’t know he has prostate cancer in the first place, how can he make an informed decision about treatment or whatever other course he may choose? That’s one of the problems with the rule of statistics.

Unlike the statistically normal, non-aggressive (albeit obviously not benign) prostate cancer, Joe Biden’s prostate cancer is said to be aggressive and to have metastasized to his bones. But it’s supposed to be treatable nevertheless. Had it been discovered earlier than stage four, however, let’s just say everything would have been better. Including treatment and prognosis.

While it would be easy to blame Joe Biden’s physicians for not diagnosing his prostate cancer earlier, is it in fact their fault when—if—they were following standard practice guidelines?

Blame it on statistics.

Incidentally, when Mark Twain opined about statistics, he was 71 or 72. And he died in 1910 at 74—of a heart attack . . .