Irresponsible health news reporting redux: the CBC on bone density & breast cancer

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.

-Greyson

Advertisements

3 Comments

Filed under gender, Health, media democracy, publishing

3 responses to “Irresponsible health news reporting redux: the CBC on bone density & breast cancer

  1. As a journalist with a special interest in health reporting, *and* an aspiring archivist, I have to say I thoroughly enjoy this blog, Greyson. You’re doing a great public service.
    I’m currently working as a researcher on a project (http://www.csjp.ca) that is critically examining – and working to improve – the state of Canadian science journalism. I agree effusively that better communication between reporters and health librarians/records managers/archivists is one of the prereqs for more ethical and informed health journalism.
    In the meantime, do keep kvetching! We need more people like you.

  2. b.d. karl

    the report on the bone density-breast cancer association study was published in 1996 in JAMA, Journal of American Medical Association, hardly a fly by night unreliable publication. Dr. Susan Love, a renowned leading breast cancer doctor has a made the connection in books for years. Had any of the orthopedic specialists i was seeing for back problems for years, or several general practicioners i also saw during those years been up to speed on this connection i could have had a breast mri and found my breast cancer before it became invasive. all of those drs repeatedly raved about my high bone density, from 1993 to 2007 – when the pain in my breast i had been complaining about since 1995 was finally diagnosed as invasive breast cancer, in both breast!!! so much for for your so called alarmist publicisty hogs. this is real, useful information that needs to be acted upon. in these cases, estrogen has nothing to do with the cancer, these women have hormone negative cancers, especialy difficult to treat, therefore early detection is even more important. the extreme bone density in these women is caused by high levels of male hormones, and lack of oposing estrogen at one point in the hormone cycle. you are very irresponsible to tell women to ignore this life saving clue. you have no right to bash a report on a subject you clearly have not even attempted to research.

    • greyson

      Dear B.D. Karl,

      I am very sorry that you have had to endure invasive breast cancer, as well as back problems. That sounds like years of pain, which no one should have to go through.

      I cannot dispute that there appears to be an association between bone mass and risk of breast cancer (and certainly between breast pain such as you apparently experienced and breast cancer).

      However, I stand by my assessment that the reporting of this recent study, from a press release only, and neglecting to even disclose the significant conflicts of interest by the study funders, is irresponsible. From the CBC coverage, one could easily conclude that bone density screening can identify people with cancer, and that high bone density causes cancer, both dangerous conclusions.

      Now that the article in “Cancer” has actually been published, we could discuss the findings, and the methodology, of this particular study. But that’s pretty much a different topic, and one on which I am much less qualified to comment.

      -Greyson

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s