How cancer news is made & a note of caution about ovarian cancer screening

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Here we go again.

The big annual conference of the American Society of Clinical Oncology meeting is still weeks away. But last week ASCO held a news briefing in which it selected six out of more than 4,000 abstracts posted online in advance of the meeting.

6 out of 40,000.

Predictably, journalists started reporting on those posted abstracts and especially on the ones highlighted in the briefing, even though:

• they haven’t been peer reviewed

• it’s difficult to get informed second opinions from other experts when the full data haven’t been presented, much less published
• the abstract may reflect unfiltered optimism for an unvetted claim.

One ASCO headline was entitled, “Promising New Ovarian Cancer Screening Strategy” building on the CA-125 blood test.

The Houston Chronicle (whose story was reviewed by us) at least injected one note of caution from the American Cancer Society’s Dr. Len Lichtenfeld, who said, “More research and refining needs to be done before it should be implemented. I can remember when doctors all rushed to adopt the Prostate Specific Antigen test, and we still don’t know how to use it.”

And on his own blog, Dr. Len wrote:

“Before we get too excited, let’s take a step back and realize that we still have a long way to go before we have an effective screening test for the early detection of ovarian cancer in women at average risk. More studies need to be done, and in fact the authors of the current report stress that they plan to move forward with those studies, including examining other tumor markers to see if they help improve the results of the current program.

We have a tendency in this country to hear news about “new science” and believe that it provides all of the answers. We tend to discount the limitations of our science and knowledge, especially when it comes to making a devastating cancer curable. Such has been the case with prostate cancer over the past 20+ years, where it has taken us that long to find out that the PSA test–although it may prevent deaths from prostate cancer–may not be as perfect as we once thought.

Let’s not make the same mistake with ovarian cancer. Is there reason to be encouraged? Absolutely. But there is still a long road to travel before we validate the concept that CA-125 is in fact the answer to our prayers for the early detection of this devastating disease.”

That didn’t stop Bloomberg news from posting a story under this headline: “Blood Test for Early Ovarian Cancer May Be Recommended for All.”

And there was a lot of other hyperbole in other stories by other news organizations.

Once again, some journalists seem to fall in love with screening stories – evidence be damned.

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Comments (6)

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May 24, 2010 at 2:57 pm

As a woman, the CA-125 has always been intriguing to me. I remember back to when there were public service announcements with Gene Wilder promoting the blood test as part of a regular exam for women, after his wife Gilda Radner died from Ovarian Cancer. So, the news about CA-125 isn’t completely new, and considering how long ago those PSA’s were, not much else has come out indicating any form of new way to screen for the often too late and fatal cancer.
I’d be curious if anyone has statistics on how many women who did use the CA-125 were found to have Ovarian cancer and if, it in fact was the reason they found out, compared to say a regular screening, without the blood work.
As far as being influenced by articles directly influencing my health care, etc., I am the type to take those articles and pick them apart finding my own data and research, call me a health skeptic I suppose. I always want more information.

Peggy Polaneczky

May 24, 2010 at 7:57 pm

I think reporting around medical meetings is getting out of hand, and the medical society PR people are as much to blame as anyone The packaging of abstracts for publication in mainstream media before a peer reviewed paper is published (or even accepted for publication) is just plain irresponsible. I don’t know how we can pull back at this point, but something needs to be done.

W Robert Lee

May 25, 2010 at 5:48 pm

Dr Schwitzer-
I enjoy your blog and encourage you to continue to do this work. I would point out one error in the post above. I know for a fact that the abstracts to the ASCO meting are peer reviewed. I did not participate in abstract review this year, but I have in past years. The level of abstract review, to be fair, is much less rigorous than reviewing an entire manuscript. I agree with your other two statements.