A Miami Herald story, heralds “Prostate cancer hits younger men.” You know right away how this one is going to play out.
The story begins by profiling a 48-year old man with prostate cancer. It says his “doctor ordered the test as a routine practice for his male patients.” There isn’t any discussion about how such ordering as a routine practice doesn’t demonstrate the kind of shared decision-making model that the American Cancer Society and other organizations recommend before screening occurs. It says that urologists strongly oppose the US Preventive Services Task Force’s recently revised recommendations on prostate cancer screening, but no one from the USPSTF is heard from in the story.
The story says that the American Cancer Society recommends: “Starting at age 50, men should talk with their doctor about the benefits and limitations of prostate screening.” I don’t think it’s splitting hairs to point out what the ACS actually says on its website:
The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about what we know and don’t know about the risks and possible benefits of testing and treatment.
Starting at age 50, talk to your doctor about the pros and cons of testing so you can decide if testing is the right choice for you.
As already noted, there’s a shared decision-making emphasis there that doesn’t appear in the story. The story mentions “benefits and limitations.” In order to make that discussion symmetrical, the common parlance is “benefits and harms” – or as ACS states, “pros and cons.” “Benefits and limitations” may convey that there are only benefits, however limited. The fact that true “harm” can occur from screening is an important part of public education.
The story also discusses treatment options.
We offer these comments as constructive criticism to help journalists realize how imbalanced their stories may be depending on whom they choose to interview and how limited is their research on the topic.
Here’s a better example: The San Francisco Chronicle published, “Debate grows over colorectal cancer screenings,” a story that reflects a much better grasp of the complexity of another screening issue. And the end result is a story that helps readers understand the healthy debate that exists on screening issues.
The story begins by noting that most health professionals agree that colonoscopy “is the best, one-shot way to screen” for colon cancer. “But,” the story’s nut graf explains, “an increasing number of experts are beginning to voice support for alternative methods, which they say could be used more widely to prevent colorectal cancer, which occurs in the colon or rectum.” More:
“some professionals argue colonoscopy has been promoted as the “gold standard” to the point that other less invasive, lower cost options such as stool-sample screenings are routinely overlooked.
“I am not against colonoscopy. I’m against it being called the best test,” said Dr. James Allison, professor emeritus of medicine at UCSF and an adjunct investigator at the Kaiser Division of Research. He argued the New England Journal report showing that the colonoscopy is better than other available and recommended screening tests was not a randomized, controlled study. …
“What I argue with is recommending everybody have a colonoscopy,” Allison said, adding that the procedure comes with a small chance of complications, such as bleeding or bowel perforation, and that less than 5 percent of polyps have the potential to turn into cancer.
“We can’t do it, the country can’t afford it, and we don’t even know if it’s the right thing to do,” he said.
This latter story is an example of journalism that informs, digs a bit deeper, doesn’t advocate for simple answers that may be incomplete, and helps readers develop critical thinking skills about health care issues.
Debate is healthy. Journalism should report on the uncertainties so as not to convey false certainty where it doesn’t exist.
Comments (2)
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Joe Hill
March 12, 2012 at 1:55 pmShared decision-making is a joke. In my experience it doesn’t exist.
For five years doctors have been badgering me to get follow-up PSA tests and biopsies after an initial test, given without my explicit consent, showed ‘abnormal’. Meanwhile they refuse to seriously investigate and treat a chronic fatigue illness which started about eight years ago and has ruined my life. Instead of finding out what’s wrong, the current primary care physician has been trying to convince me that the fatigue is a symptom of prostate cancer, even though all of my ‘plumbing’ works fine.
Anybody in the U.S. with an invisible illness is assumed to be a lazy welfare bum, who enjoys living in extreme poverty and fighting with useless doctors. At this point in my life, dying from cancer would be a relief, compared to the daily struggle to survive in a vindicative society dominated by a corrupt medical industry.
Joe Hill
March 12, 2012 at 1:55 pmShared decision-making is a joke. In my experience it doesn’t exist.
For five years doctors have been badgering me to get follow-up PSA tests and biopsies after an initial test, given without my explicit consent, showed ‘abnormal’. Meanwhile they refuse to seriously investigate and treat a chronic fatigue illness which started about eight years ago and has ruined my life. Instead of finding out what’s wrong, the current primary care physician has been trying to convince me that the fatigue is a symptom of prostate cancer, even though all of my ‘plumbing’ works fine.
Anybody in the U.S. with an invisible illness is assumed to be a lazy welfare bum, who enjoys living in extreme poverty and fighting with useless doctors. At this point in my life, dying from cancer would be a relief, compared to the daily struggle to survive in a vindicative society dominated by a corrupt medical industry.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like