ABC reports on screening questions and STILL ends up endorsing screening

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On the very day that we announced that would no longer systematically review network TV health news stories, we were provided two fresh examples – both on ABC – of the sorry state of many network TV health news efforts.

Reporting on the two studies in the Journal of the National Cancer Institute that raised important questions about both prostate cancer screening and breast cancer screening (at least the role of clinical breast exams), ABC still managed to end up with strong statements of endorsement – DESPITE the evidence on which they just reported.

On ABC’s World News Tonight, reporter Dan Harris turned to a New York urologist for his only expert interview on the prostate issue. He didn’t interview the authors of the study. Nor Dr. Otis Brawley of the American Cancer Society who wrote a powerful accompanying editorial. He only turned to a urologist, who makes his living off of diagnosing and treating prostate cancer.


Harris asked the urologist: “Seeing this study, one is tempted to conclude that you should stay away from early screening. Is that the right conclusion to reach?”

The urologist responded: “That’s absolutely the wrong conclusion to reach. …You should be screened because if you had cancer you’d want to know about it.”

Harris’ conclusion: “Bottomline: doctors we spoke with today said you should still go for early screening but you should know that these tests are not foolproof.”

Harris said they spoke with “doctors” (plural). Viewers should ask: which doctors? Who were they? Were they all urologists? Why didn’t you have the authors appear (one of whom is a urologist)? We only heard from one urologist.

Savard.pngThen, on ABC’s Good Morning America this morning, medical contributor Dr. Marie Savard reviewed the two studies. Savard wrapped up her discussion with anchor Diane Sawyer by emphasizing that the digital rectal exam (one prostate screening option) “is still important.”

Savard: “Men you still need to appear every year and get checked.”

Diane Sawyer “You’d rather have a false positive than something missed.”

Savard’s opinion and Sawyer’s rhetoric clash with the recommendations of major scientific and medical organizations, which don’t differentiate between PSA tests and digital rectal exams.

On the American Cancer Society website are these statements:

Neither the PSA test nor the DRE is 100% accurate. Abnormal results of these tests don’t always mean that cancer is present, and normal results don’t always mean that there is no cancer. Uncertain or false test results could cause confusion and anxiety. Some men might have a prostate biopsy (which carries its own small risks, along with discomfort) when cancer is not present, while others might get a false sense of security from normal test results when cancer is actually present.

No major scientific or medical organizations, including the American Cancer Society (ACS), American Urological Association (AUA), US Preventive Services Task Force (USPSTF), American College of Physicians (ACP), National Cancer Institute (NCI), American Academy of Family Physicians (AAFP), and American College of Preventive Medicine (ACPM) support routine testing for prostate cancer at this time.

Over and over and over I have written about how many news organizations stick to the pro-screening message despite the best and latest evidence.

ABC News has done it again – twice – in different programs.

There were opportunities here to drive home the importance of shared decision-making, to explain the uncertainties, to show how there isn’t one best choice for all people. But despite the fact that they reported on the studies – mostly accurately – they still left viewers with strong screening endorsements at the end of both programs.

That’s advocacy, not journalism.

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September 1, 2009 at 11:26 am

As a breast cancer survivor (coming up on 5 years) I must respectfully disagree with Mr. Schwitzer’s position on early screening for cancers. My sister died from breast cancer in 2001, and my mother-in-law had a brush with it, so I have encouraged my 31 year old daughter to start screening early. It will at least lay down a baseline to compare to, and as there is an increase in breast cancer in younger women, it may find a problem while it is more successfully treatable. I agree there are the profit motivated medical professionals in every field. I also believe the patient has the responsibility to question, to become informed, to use their common sense, and to seek the opinions of other informed sources. I think it dangerous to make a blanket statement against early screening. People already put off too long routine exams and physicals, women as well as men.

Gary Schwitzer

September 1, 2009 at 12:32 pm

I did not write about “my” position on early screening.
I do not have a position on early screening. That should be a matter of individual choice.
I have a strong position about how information on early screening is communicated – framing that may wrongly and harmfully influence individual choice.
Your choices are yours.
The choices you’ve made, based on an unfortunate family history, may not make sense for someone who does not share that family history. News stories reach the entire population – not just those at higher risk because of family history.
I made no “blanket statement” against early screening as you imply.
You must have missed what I wrote about the stories in question:
“There were opportunities here to drive home the importance of shared decision-making, to explain the uncertainties, to show how there isn’t one best choice for all people.”

Aaron Shrider

September 2, 2009 at 8:42 am

I wonder sometimes if these reporters even do any research before they report on a story, or if it is just someone hands them a piece of paper with some generic facts right before they interview someone. It seems to me that more and more you get t.v. reporters that care less about reporting actual facts and quality news and care more about how they look on camera. I don’t trust anything I hear about health on the news anymore because they are always contradicting themselves. I watch from time to time and then look up the information on the web or in a magazine. It has gotten to a point to where the reporters reporting on these health stories don’t really care about their stories they just want to get on t.v. in hopes of someday being an anchor.

john reid

September 2, 2009 at 9:44 am

Screening for any disease should be an informed decision by the patient. An informed decision. Informed means to know and accept the risks and benefits associated with screening. The Singer editorial speaks to the important issue…, men need to know, understand and agree to the potential outcomes…, good and bad, of screening.
The U.S Preventive Services Task Force Recommendation Statement on Screening for Prostate Cancer:
‘Current evidence is insufficient to assess the balance of benefits and harms of screening for prostate cancer in men younger the age 75 years (I Statement).
Do not screen for prostate cancer in men age 75 years or older (Grade D recommendation)
The vast majority of men undergoing PSA screening for prostate cancer simply don’t know the implications. For their health and well being, they should.