Michael Joyce is a writer-producer with HealthNewsReview.org and tweets as @mlmjoyce
It’s a question doctors have been eager to study for some time. And this week a Danish study published in the New England Journal of Medicine provides some important, albeit observational, data.
If you heard about the study in a news story, you may have read or heard very different take-home messages than what other news consumers received from other news sources.
Dozens of news organizations covered this study. Below, I compare the coverage of five of them. I wouldn’t label it “The Good, The Bad, and The Ugly,” per se.
How about “The Very Good, The Not-So-Bad, and The Pretty-Darn-Ugly”
The New York Times was one of the outlets that set a very high standard by making the following key points quite clear:
And New York Times reporter Roni Caryn Rabin was the only reporter I came across who noted that the study was funded by Novo Nordisk, the company that makes Vagifem, a topical estrogen marketed for menopausal symptoms. She also pointed out that two of the study authors, including the lead author, “have been employed by Novo Nordisk since the manuscript was accepted for publication.”
NBC News.com touched on most of the above points covered by the Times. They appropriately emphasized the “small risk” high up in the story and provided this important context as well:
“It’s a disappointment to doctors who had hoped that lower doses of hormones in both oral and non-pill contraceptives might be safer than older birth control pills. But they stress there is no need for most women to abandon birth control pills for fear of breast cancer.”
The Guardian also included many of the most important points. They also highlighted some other aspects of the Danish study that many women on birth control would be curious about. Most notably, how the length of time on hormones affects risk: “among women taking the pill for five years, the study suggests, there would be an extra one case for every 1,500 women.” But this increased risk gradually disappeared over a few years after stopping the pill.
The Guardian also included this important quote from Kevin McConway, a statistician at the Open University in England who specializes in risk communication in the media:
“Like most other studies on hormonal contraceptives and breast cancer risk, this one is observational, so it cannot proved conclusively that the hormonal contraception is definitely the cause of the increased risk.”
Although Bloomberg covered some important ground in their reporting, they probably warrant a demotion to “The Bad” based on two things. First, the headline:
“Those Newer Birth Control Pills Don’t Lower Cancer Risk”
Notice they didn’t write ‘breast cancer’? A potentially massive oversight for those who don’t go past the headline and rush off to tell their friends: “birth control pills cause cancer!”
Speaking of massive, check out their opening line:
“Hopes that different formulations would remove a longstanding danger to women are dashed by a new study. Newer birth control drugs developed to replace those tied to cancer risk were thought to improve safety for the women who took them. It turns out they didn’t, according to a massive new study”
It’s a misleading one-two punch without context. The headline’s misleading generic reference to cancer is followed by unwarranted “dashed hopes” in the body text. Only further down in the article do we learn the relative risk of “about one extra case of breast cancer among every 7,690 women taking the drugs.”
But the damage has already been done.
Newsweek wasted no time with this fear-mongering headline: “Breast Cancer: Birth Control May Increase Risk By Up to 38 Percent”
This is the relative risk after 10 years on hormonal contraception. As with the Bloomberg framing, it’s only toward the end of the article that we’re provided with the much less startling absolute numbers.
The ending hits readers with a bizarre twist. Rather than point out that hormones may play a protective role in ovarian, endometrial, and possibly colorectal cancer …Newsweek finishes with this:
“… birth control may actually be protective against cancer on the whole, despite this increased risk for one type”
I can’t imagine what a roller-coaster ride that is for readers to go from that threatening headline to such a hopeful (albeit, very misleading) closer.
We see this reporting roulette frequently. The quality of information that readers end up with is a spin of the wheel. The spectrum — as in this case — can be alarmingly wide. In cases in which the topic is esoteric the impact of this on consumers could be argued to be negligible. But in the case of oral contraceptives we’re talking about roughly 10 million woman in the United States alone. The impact of misinformation on this scale can become a public health issue.
I was encouraged that most of the reporting on this study was solid. The odds were fairly good that interested readers would walk away empowered with relevant information.
For those with an unlucky spin, I find myself left with a nagging concern: do they realize their bad luck?