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More conflicted, imbalanced prostate information from FOX News

Conflicted and imbalanced because they let Dr. David Samadi, who runs a robotic surgery center in New York, be the unchallenged expert about “raising awareness for prostate cancer.”  In fact, they let the self-promotional Samadi get away with promoting the #SamadiChallenge – which, if you use that on Twitter, will eat up 16 of your available 140 characters to say anything meaningful.  Samadi explained the Samadi Challenge this way:

“Getting women involved.  Women go for their pap smears.  They go for a mammogram.  And now they have one more thing to worry about, which is the PSA and also their testosterone to check.”

What an effective message:  Worry.  Worry.  Worry.

By the way, I’m sure he didn’t mean that women need to worry about their PSA level or their testosterone level.

Meantime, a graphic reading “GIRL POWER” appears across the bottom of the screen.

The segment is filled with misleading information. .

  • It begins with the statement that “1 in 6 men are affected by prostate cancer.”  That is one of the most abused statistics in all of health communication.  It is the lifetime risk of prostate cancer – spread over a man’s lifetime.  But for any man of any age, the numbers look quite different.  The National Cancer Institute reminds us:

“the probability of being diagnosed with prostate cancer is 1 in 298 for men 49 years or younger, 1 in 43 for men aged 50 through 59 years, 1 in 16 for men aged 60 through 69 years, and 1 in 9 for men aged 70 years and older, with an overall lifetime risk of developing prostate cancer of 1 in 7.”

  So, for men in their 40s – often targeted as the key starting age for men to start worrying about prostate cancer screening – the risk is 1 in 298 – not 1 in 6. Samadi’s prostate cancer center offered free prostate cancer screening to men over 40 last Saturday.  Even the American Urological Association’s independent panel “does not recommend routine screening in men between ages 40 to 54 years at average risk.”

  • The Fox anchorwoman serves up this softball to Samadi:  “Correct me if I’m wrong, Doctor, is prostate cancer nearly 100% curable or at least preventable to the point where they won’t die?”   I’ll answer that.  Yes it is.  And when something is nearly 100% curable, it begins to raise questions about what it is you’re curing.  Look at this key graphic from the National Cancer Institute.  Since the explosion of use of the PSA blood test in the ’90s, we’ve found a lot more prostate cancer.  But you can see that the death rate has stayed the same – strange, isn’t it, in the face of all of those new cases? So, the 5-year survival rate looks like it is skyrocketing.  But is it?
  • Much of that increase may be due to what’s called lead-time bias.  If two people get on a train headed for Washington, but one gets on in Boston and one gets on in New York, and the train crashes in Washington, killing both, you could say that the person who got in Boston was a longer-term survivor of the train ride.  But it’s only because he got on earlier.  You can say that prostate cancer survival is approaching 100%, but it may only be because you diagnosed men earlier, often diagnosing them with earlier cancers (some call it pseudo-disease) that may have caused them no harm in their lifetime.  Yet they went on to treatment, with its own known complications.  And then you tell them they were cured.  Absolutely none of this important nuance was reported by FOX News, which is not surprising, considering who the messenger was.
  • Samadi got in another bit of self-promotion describing prostate cancer treatments, in this way:  “We have all the treatments, whether it’s robotics or other things – which is what I do.  It’s all out there.  So I hope you join the Samadi Challenge.”

Let me emphasize:  this is not an anti-prostate cancer screening message.  But it is a strong warning for men against conflicted, imbalanced messages that may mislead men.  Dr. Otis Brawley of the American Cancer Society has said in the past:  “We’re not against prostate cancer screening. We’re against a man being duped and deceived into getting prostate cancer screening.”

FOX News should think long and hard about what they’re doing.

ADDENDUM:

For contrast, read Pittsburgh urologist Benjamin Davies’ thoughtful piece on Forbes.com, “Prostate Cancer Awareness Month: A Double-Edged Sword.” In it, he concludes:

“Prostate Cancer Awareness Month is a double edged sword; on the one hand,  I want healthy patients screened but I also want those same patients to embrace the problems of prostate cancer screening.  Patients should not fall for the casualness that has creeped into the general conversation.  That is the reason I am generally opposed to mass screening programs – they can not and do not create an atmosphere for informed decision making.  It can be challenging to embrace nuance but that is the state of prostate cancer screening and treatment.  We should not be promoting individual surgeons as if volume makes the man.  We should be promoting increasing basic science research efforts, collaborative surgical science studies, and informed decision making.”

That hyperlink in that excerpt, as you’ll see, goes to a David Samadi news release.  Enough said.

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