Can you stand to hear me kvetch again about irresponsible health reporting?
Today it’s the CBC (among others), whose health headline screams: Bone density level may act as predictor of breast cancer
It’s one of those articles without a byline, and the nameless reporter who penned this brief article clearly has no idea what they are talking about. But I guess fearmongering is always a good story-seller, so they wrote an article anyway. They must have been in quite a rush, however, as not only is this yet another article written based only on a press release about a forthcoming article, the press release isn’t even quoted correctly.
The article begins:
In addition to mammograms, ultrasounds and blood tests, doctors may have a new tool in their breast-cancer-screening arsenal.
Off to a bad start. Bone density testing is not used like a mammogram or ultrasound, both of which are used to detect masses that may indicate cancer. I mean they’re all imaging tests, but there is nothing in bone densiometry that can indicate a suspicious lump in your breast for investigation. It seems that the article in question here is about screening for risk factors, which one could liken to blood tests if you’re talking about the small minority of breast cancers that are linked to the BRCA 1 & 2 gene variations found in 0.1-0.6% of the US population…but even that is a stretch.
The article about the unseen-article states that:
In the study, 10,000 post-menopausal women with an average age of 63 were studied in 40 health centres in the U.S.
without mentioning the critical context that this study was done on Women’s Health Initiative participants and is part of the WHI study backlash/follow up wave we are currently riding.
The CBC delivers the article punchline that:
Higher bone mineral density, which is governed by hormonal levels in a woman’s body throughout her lifetime, may lead to a higher a risk of breast cancer.
Without mentioning the CRITICAL fact that the study was funded by the Eli Lilly Company. Lilly, incidentally, makes Raloxifene (aka Evista, Keoxifene), a newish bone density drug that – unlike the older bisphosphonate class of bone density drugs – may reduce the risk of breast cancer.
Wait, you mean to say that a study that says that high bone density could be linked with higher risk of breast cancer, funded by a company making a drug that builds bone density while allegedly decreasing risk of breast cancer might be victim of conflict of interest? Crazy. </sarcasm> Of course, we can’t evaluate for ourselves because the full article isn’t available…but we’ll get to that later.
Raloxifine, of course, has been struggling to gain market share against the older bisphosphonates in the face of a black box warning (for Increased Risk of Venous Thromboembolism and Death from Stroke) and multiple FDA warning letters for direct-to-consumer advertising practices in violation of federal guidelines (and if you know how rare it is for the FDA to actually send these letters, you know these must be rather egregious violations!). Not hard to imagine that the maker of such a drug might wish to have some studies encourage new prescriptions.
It would have been nice – ethical even – to have some context for this article’s findings: not only the study’s funding source, but also an idea of how prevalent the problems of osteoporosis, breast cancer, and cardiovascular disease are for postmenopausal women. Want it? It’s not hard to find (pdf here). Almost 39% of deaths among women 65+ in the US are due to heart disease or stroke. 19.3% are due to all cancers combined. 1.8% are due to unintentional injuries, and even if you attributed every single pneumonia death to a fracture and hospitalization (common but certainly not the only way to die of pneumonia) that only adds an additional 1.6% of all total deaths. While personal and family medical specifics make a lot of difference in terms of the weight given to risk factors, it’s a no-brainer that cardiovascular events should be a bigger concern than bone fractures as far as preventable deaths in postmenopausal women. It’s not rocket science here; I’m a librarian not a doctor. Finding this info took only a mere Google search, not even a single subscription database. A health journalist should be able to provide this context too.
Finally, in case you were a CBC reader who happened to be health literate enough to question the, er, thoroughness, of the news clip and wanted to go to the full article to read it, the CBC includes a final sentence:
The study is published in the July 28 issue of Cancer.
This would be quite helpful, were there a July 28 issue of the journal Cancer. However, Cancer is published on the 1 and 15 of each month. As of today there are not any “early view” articles released on the 28 either, nor does this article appear in either the July 15 or August 1 issue. Way to fact check, CBC.
(For those who are interested in the actual study, please note that this article should be found in the September 1 issue of Cancer.)
A better example of quick but accurate health reporting from a pre-publication press release can be found here. CBC, please take note. You’re supposedly the national public broadcaster. I expect better.
Is it too impolitic for me to say that I hope the good folk over at Media Doctor let the CBC have it over stuff like this? Hmm…perhaps what I ought to be doing is talking with fellow health librarians about how we can better reach our health beat journalists in order to make it easier for them to write accurate articles. Okay, okay, I’ll do that. But I’m still gonna kvetch about irresponsible reporting in the meantime.