Health News Review

Veteran reporter Richard Knox, with a next-day folo, delivers the best analysis we’ve seen or heard yet on the National Lung Screening Trial, which reports a benefit from CT scan screening of current and former heavy smokers.

(Please note: in our systematic reviews on HealthNewsReview.org, we reviewed four print stories. See reviews of the AP, New York Times, USA Today and Reuters stories.)

Listen to the balance and perspective, including skepticism that “it’s too early to know if this ready for prime time.” He includes the number needed to screen of 300 – meaning 300 would need to be scanned in order for one life to be extended. (That means the other 299 would have to be scanned, run the risk of false positives which was initially reported to be 25%, run the risks of followup testing and treatment, and incur the costs of scanning and additional testing and treatment – not an insignificant bundle of issues.)

By comparison, CBS’ Dr. Jon LaPook didn’t include any interview expressing any caution about interpreting the study, and said, “the new study suggests the benefit of finding lung cancer early trumps the risks.” While LaPook went on to discuss the number needed to screen, false positives and costs, the imbalance in interviews and in that “benefit trumps risks” statement may be what sticks with viewers.

Somewhat similarly, NBC News covered costs, risks, false positives, and ensuing unnecessary testing and treatment, but didn’t include the number needed to screen and didn’t include interviews with anyone expressing any caveats. NBC’s most troublesome line: that this “has been a huge controversy for years but researchers resolved it.” Not quite! Their story did disclose that GE, parent company of NBC, is a player in this field.

At the other extreme, ABC News had the least balanced report. Its lead-in graphic called this a “breakthrough.” Contrast that with the NPR expert interviewee who said it’s too early to know if this is ready for prime time. And ABC used the tired “Holy Grail” line. It featured conflicted CT scan advocate Dr. Claudia Henschke crying over the news. It used the word “cure” and featured a man it said was “one of the lives she (Henschke) saved.”

Overall, this has been a troubling week for news coverage of various screening tests. It’s nice to be able to point to some examples – like Dick Knox’s NPR report – of what can be done when a smart, veteran reporter is given time to give appropriate context.

Addendum: More analysis by NPR and Knox was posted today. This one was headlined, “How Questions About Mammography Apply To CT Scans For Lung Cancer.”

Comments

Michael Kirsch, M.D. posted on November 5, 2010 at 6:23 pm

Keep in mind that the current study, is contradicted by prior studies. One study shouldn’t change the course of medical practice, particularly since tomorrow’s study may refute it. Three hundred have to be screened to save a life. This means 299 receive radiation, consume health care dollars and then are forced into the medical arena when their scans demonstrate false positive ‘abnormalties’ that must be pursued. Of course, if my life were saved by the strategy, then I would think it was worth it. This must be balanced against billions of dollars spent and a decrease in the quality of life for patients whose scans reveal incidental lesions.
Is saving even one life worth it? If so, then we should lower the highway speed limit to 40 mph.

Dr K.S.Parthasarathy posted on November 8, 2010 at 6:48 pm

A few years ago, if any one argued that a little radiation exposure is beneficial, it would have elicited a smirk followed by a grin.Not any more.Now a few ardently support ‘hormesis”, a controversial concept.
In one radiation safety-related news group, a few argued that the reduction in cancer deaths among those who underwent CT scan examinations is due to the beneficial effects of radiation. At least one of them claims that he keeps thorium rods below his bed to ensure that he regularly gets exposed to a steady, health promoting, low level radiation exposure!
K S Parthasarathy Ph.D

Tabitha Powledge posted on November 9, 2010 at 10:23 am

The News Hour handled it via a decent interview with NCI head Harold Varmus, which was full of appropriate cautions. I am wondering what you think of handling a tricky story this way instead of doing a news piece. I assume Varmus agreed to do an interview because he was concerned about exactly the coverage problems you point out–and of course the News Hour is one of the few places around where it’s possible to handle the story in this way.

Timothy R. Church posted on November 10, 2010 at 6:33 pm

Gary, as the principal investigator of the University of Minnesota site for NLST, I have to say your analysis of the news coverage is right on the mark. NPR did such a great job of covering the issue. I have to also commend both the Star Tribune and the Pioneer Press, whose reworking of the national wire material was very thoughtful and thorough.