Health News Review

An informative take on the value of a new breath test for detecting colon cancer. Better than the competing WebMD coverage.

Our Review Summary

This story addressed many of the issues that we like to see covered in discussion of experimental diagnostic tests. It explained that this test is not ready for prime time and probably won’t be any time soon. It emphasized that the results of a small study cannot tell us how the test will perform in the real world. It explained that there are already effective diagnostic tests for colon cancer that aren’t being optimally used. It included perspective from an expert who explained potential benefits and drawbacks of the new test. Overall, a very good report.


Why This Matters

In any story about diagnostic testing or screening, the discussion has to go beyond how many people with the disease were correctly identified. We also need to hear about how many people without the disease were incorrectly identified (i.e. false positives), and what harms those individuals may face as a result of the incorrect test. Of the two stories we reviewed about the same experimental colon cancer test, only HealthDay made readers aware of this important distinction.


Criteria

Not Applicable

Does the story adequately discuss the costs of the intervention?

Not Applicable

Costs were not mentioned, but since this test is in an early stage of development, it would be difficult to provide an accurate cost figure. That figure would have to include both the cost of the test and any unnecessary follow-up tests and procedures due to false-positive results.  We’ll rule it not applicable.

Satisfactory

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

Both this story and the competing WebMD piece repeated the accuracy statistic provided by the study (76%), but neither story provides much detail as to what this figure means. Good diagnostic tests not only have to be able to identify people with diseases correctly, but they also have to be able to rule out people who don’t have the disease correctly. Ideally the story should report true positive rate (sensitivity) and the false positive rate (1- the specificity), though it’s not clear that the percentages listed represent those rates. We would have preferred to see the absolute numbers of people in each group (the cancer patients and controls) who were accurately diagnosed, and a comparison of how that stacks up against currently available tests.

This story did note that the primary benefit of a breath test would be increased convenience and less of an “ick” factor compared with existing tests. In addition, it pointed out that a 75% accuracy rate is a failure for 25% of patients — a nuance missing from WebMD’s coverage. In also explained that we don’t whether this kind of test can detect precancerous polyps, which should ideally be identified and removed before they have a chance to develop into cancer.

A mixed bag, but overall, it meets our standard for a satisfactory.

Satisfactory

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story mentioned that this test would inevitably produce false-positive results that would lead to needless invasive follow-up tests.

Satisfactory

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story sprinkled useful caveats throughout the coverage:

  • “small pilot study”
  •  “don’t hold your breath” waiting for your doctor to provide the test
  • “There’s no way to tell if this would work in the general population.”
  • “This study raises more questions than answers.”
Satisfactory

Does the story commit disease-mongering?

Satisfactory

There was no disease-mongering of colon cancer.

Satisfactory

Does the story use independent sources and identify conflicts of interest?

Satisfactory

An expert from the American Cancer Society provides much-needed context and perspective on this research.

Satisfactory

Does the story compare the new approach with existing alternatives?

Satisfactory

The story discusses existing options for colon cancer screening, and what some experts think are the appropriate ages and intervals at which these tests should be done.

Satisfactory

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

It’s clear from the story that this test won’t be available any time soon.

Satisfactory

Does the story establish the true novelty of the approach?

Satisfactory

The story acknowledges that the idea of using a breath test to catch cancer is not new, and mentions other relevant research.

Satisfactory

Does the story appear to rely solely or largely on a news release?

Satisfactory

It doesn’t appear that the story relied inappropriately on this press release.

Total Score: 9 of 9 Satisfactory


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