September 12, 2013
Let me count the ways I’m troubled by this NBC News.com “cookies & cancer” story
The story came to my attention when I saw Twitter comments such as “How not to communicate about cancer risk factors. Oy.”
That was in reference to an NBC Today Health website piece entitled, “Drop the cookie: Sweet, starchy foods ‘probably’ cause women’s cancer.” It was based on the report, whose cover page appears at right.
Many things bother me about this online piece. First, regarding the content:
- The headline. Linking cookies with cancer in the headline isn’t much better than this week’s “smaller testicles make better Dads” headlines.
- The story said nothing about the limitations of the analysis in question. Nothing about the hierarchy of evidence – and that not all evidence is equal. Somewhere in the story, there could have been a line about how observational studies can’t prove cause and effect, but they can point to strong statistical associations which can guide public health decisions.
- The story states: “Sweet, starchy foods like sugar and white bread probably cause endometrial cancer, while coffee probably protects against it, researchers reported on Tuesday. And a review of the available evidence reinforces that being obese is probably the greatest cause of the cancer.”
Why not include the following chart from the report itself, which may communicate better what the researchers were trying to convey?
- Wouldn’t that be more accurate than using active, causal phrases such as “Drop the cookie”…”surprising findings the degree to which coffee can protect against the cancer”…”eight studies showing coffee lowers risk.” Such studies can’t prove that coffee “protects” against cancer. Such studies can’t prove that coffee “lowers” risk. That doesn’t make them unimportant. But it is inaccurate to use cause-and-effect terms to interpret the findings as something they are not. They show strong statistical associations. So it’s OK when the authors say things like “very, very strong association with obesity” or “People who are more active regularly tend to have a decreased rate of endometrial cancer.” Association and “tend to have a decreased rate” are not statements of causation. The authors were correct. The story crossed a line.
But now I’ll shift gears to the user experience of what it was like for me to read the piece online. The hyperlinks from words in the story to ads were ridiculous. So, for example, when the story talked about the World Cancer Research Fund, the word Fund, was hyperlinked to a Charles Schwab ad! As in Charles Schwab fund management!
When the story discussed rates of cancer, the word rates was hyperlinked to another Schwab ad for stock trading.
And when the story mentioned estrogen, that word was hyperlinked to an ad for a panty liner.
So let me summarize:
- The story botched the risk communication, just as the early morning Twitter message said it did.
- The user experience was ridiculous.
And this, my friends, is the way we will increasingly get our health care news.
When I first posted this, I hadn’t read the online reader comments on the NBC Today Health website. It’s one indication of how turned-off people are by this kind of news. Some excerpts:
- “Here we go again. Proof if you wait long enough, there will be a study saying something is good, a study saying the same is bad. … Give us a break.”
- “Another probably or may. Hm, who cares about this sh.t? Come with facts or don’t write stuff about nothing. Idiot journalists.”
- “This article is misleading…extremely poor article writing.”
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