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Hormones linked to cancer

Rating

3 Star

Hormones linked to cancer

Our Review Summary

First, this is another example of a local paper (Cincinnati Enquirer) taking a machete to an original AP story.  AP’s version ran 939 words – hardly too much for a story of such widespread women’s health interest.  The Enquirer slashed it to 369 words, removing much of the context.  

 The biggest flaw with this article is its headline and lede, which emphasize the conclusion that taking hormones for menopause doubles risk of breast cancer. No data is provided to justify this claim, which is significant in the context of previous WHI data.

It is premature to say that this would "end any doubt that the risks outweigh the benefits for most women." Debate continues about the full spectrum of harms/benefits.

Most women need better information and the opportunity to make their own decisions based on a 360 degree view of the issues. The hormone treatment discussion has been driven by fear for a long time, not the big picture, and this piece undermines the possibility of "discussing" the issues rather than pushing a position.

The study author is quoted saying the findings "change the balance" on whether to start hormone treatment at all, but it’s hard to know what she means by this.

The story could have been wrapped around the fresher finding: that breast cancer risk builds over time as the pills are taken and declines to nearly pre-treatment levels within two years of stopping. The story mentions this in paragraph two and includes a quote about it.

Had it been the central point the story would have provided a more valuable takeaway.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

The story does not report the cost of the drugs.

While price is not essential in a story like this, as a rule costs should be reported. 

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story opens by stating that taking hormones "doubles the risk of breast cancer." The source of this statement is not provided, nor is even a mention of where to find the source. In any event, if the statement is correct it is unnecessarily provocative.

The reporter recovers in the last paragraph, stating that "most women will not get breast cancer by taking the pills in the short term," adding that a couple of years of hormone use translates into "a few extra cases of cancer a year" per 1,000 women. But again, it’s not clear what data that assessment is based on. 

In any case, the information at the bottom should have appeared much higher up. 

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story focuses on the harms of hormone pills.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The news report is based on a presentation at a medical meeting.

While the underlying data from the Women’s Health Initiative have been widely published and analyzed, the reporter should have indicated that these particular findings have not been peer-reviewed or published.

For this reason the story fails to achieve a "satisfactory" rating under this criterion.

Also, it is premature to say that this would "end any doubt that the risks outweigh the benefits for most women." Debate continues about the full spectrum of harms/benefits.

Does the story commit disease-mongering?

Satisfactory

The report does not exaggerate the risks or consequences of taking the pills. [Though see "Quantification of Benefits of Treatment," below]

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

In the original AP version (939 words long), the reporter quoted 5 expert sources.  In the vastly cut-down Cincinnati version (369 words), only two sources appeared. 

It does not appear that anyone independent of the study in question was interviewed.   

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story reports that women who take hormones for severe menopausal symptoms should do so at the lowest dose for the shortest time possible.

It should have briefly mentioned that other interventions are available to treat the conditions for which the hormones were widely prescribed, including heart disease and osteoporosis.  

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story makes clear that estrogen and progestin pills remain available, but are to be prescribed with awareness of risk/harm tradeoffs. 

Does the story establish the true novelty of the approach?

Not Applicable

The novelty of the treatment is not in question.

Does the story appear to rely solely or largely on a news release?

Not Applicable

There does not appear to be a press release linked to this story.

Total Score: 3 of 7 Satisfactory

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