CNN has been giving viewers screening test advice that does not reflect the best medical evidence.
In my last Publisher’s Note I pointed out how CNN’s on-air advice conflicted with evidence-based guidelines when it advised men in their 40s, 50s and 60s about screening tests they should have. That segment was broadcast in February.
In May, on Mother’s Day weekend, CNN did the same thing in promoting screening tests for women. At one point in the broadcast, CNN medical correspondent Elizabeth Cohen said, “So to be clear, don’t wait to be sick to get tested. Starting in your 30s you should be getting regular heart health tests, thyroid tests and skin exams. That’s in addition to your yearly gynecological testing.” While she spoke, a graphic appeared on-screen reading:
I asked Michael Pignone, MD, MPH, Associate Professor of Medicine in the Division of General Internal Medicine at University of North Carolina – Chapel Hill to react to this on-air advice. Regarding the vague “heart health tests” recommendation, Pignone says, “If this means screening for hypertension and lipid disorders and smoking cessation, it is reasonable. But not electrocardiograms (ECGs) or other imaging studies.” Unfortunately, CNN did not specify which heart health tests they were talking about, so viewers could easily have been misled.
What about the thyroid test recommendation? “This is not recommended for young women who don’t have symptoms,” says Pignone. He also says the “yearly skin exam” recommendation is controversial, lacking a strong evidence base.
While reporter Cohen’s phrase, “your yearly gynecological testing,” was vague, a graphic appeared on screen that specified “pelvic exam, pap smear.” Pignone says there is good evidence for Pap smears to detect cervical cancer but no good evidence to support pelvic exams in women without symptoms. Younger women, he points out, may benefit from chlamydia screening. But as with the heart testing recommendation, CNN’s vague advice was less complete than it should have been.
Later in the broadcast, CNN gave the following advice to another age group of women: “In their 40s women need to start having mammograms, and at 45 they need to have regular diabetes testing.” The “need to” terminology is troubling. Mammograms probably have some benefit for women in their 40s but it is modest, according to Pignone, and screening in this age group leads to a high rate of false alarms. Diabetes screening in the general population of women this age is also controversial.
It appears that CNN is trying to help people with these screening test recommendations – in February for men of different ages and in May for women of different ages. But viewers need complete information on potential harms as well as potential benefits of such tests. To promote screening in groups for whom the evidence of benefit is not clear and for whom the evidence of some harm is significant is not good journalism. It is a form of advocacy journalism that is advocating the wrong things.
Consumers – and journalists – can be guided by the work of the U.S. Preventive Services Task Force, a group of medical experts convened by the federal government to conduct rigorous, impartial assessments of scientific evidence and develops recommendations for clinical preventive services.
I’ll end with a line often attributed to Mark Twain. (But, in the spirit of this commentary, some question the accuracy of that attribution.)
“It ain’t what people don’t know that hurts them. It’s what they know that ain’t so.”