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A protein may detect colon cancer’s spread

Rating

5 Star

A protein may detect colon cancer’s spread

Our Review Summary

Molecular diagnostics is a new and rapidly developing area in cancer diagnosis and treatment. In theory, molecular diagnostic techniques would allow the identification of tumor cells not previously detectable by traditional pathology, in order to guide decisions about chemotherapy treatment after surgery. This process is already well on its way to being established as routine care in the treatment of breast cancer. However, a new paper published in this week’s Journal of the American Medical Association raises questions about its utility in treating colon cancer.

The story states that Diagnocure has launched the test, but it is not clear how widely available it is and how an individual would go about getting it. The story also mentions the high cost of the test – $3,600. The story should have commented on whether insurance is likely to cover it and how this cost compares to traditional biopsy and pathology without GCC testing.

The story could have been improved by focusing more attention on the potential harms of the test – most notably the high numbers of false positives in the study. In the study, 79% of those who tested positive for the cells did not have a recurrence of cancer after two years. While it is true that some of them may go on to develop cancer later, many of them will not. A false positive result in this case would lead someone to undergo chemotherapy (which has signficant side effects) even when they are unlikely to benefit from it.

But it was noteworthy that the story delivered this key nut graf:  

"But the findings…also illustrate the increasingly blurry line between experimental tests and commercialized versions.  With the advent of new ways to analyze the abnormal activity of genes and B proteins in diseased tissue, novel molecular tests are being rushed to market, despite little oversight and unanswered questions about how to ensure safety and reliability."

That line – and a quote from a Cancer Society official that the test is "not ready for prime time" delivered all the context any reader should need to evaluate the evidence.   

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story mentions the high cost of the test – $3,600. The story should have commented on whether insurance is likely to cover it and how this cost compares to traditional biopsy and pathology without GCC testing.

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

Satisfactory

The story adequately quantifies the number of cancer recurrences in those who test positive and those who test negative.

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

Not Satisfactory

The story does not mention any potential harms of the test – most notably the high numbers of false positives in the study. In the study, 79% of those who tested positive for the cells did not have a recurrence of cancer after two years. While it is true that some of them may go on to develop cancer later, many of them will not. A false positive result in this case would lead someone to undergo chemotherapy (which has signficant side effects) even when they are unlikely to benefit from it.

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

Satisfactory

The story adequately describes the current study.

Does the story commit disease-mongering?

Satisfactory

The story does not exaggerate the seriousness of colon cancer or the importance of staging in deciding how to treat it.

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

Satisfactory

The story quotes one expert from the American Cancer Society who is not listed as a researcher on the current study or employed by a manufacturer of the test.

Does the story compare the new approach with existing alternatives?

Satisfactory

Clearly traditional biospy and pathology is the alternative to biopsy plus the GCC test.

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

Satisfactory

The story states that Diagnocure has launched the test, but it is not clear how widely available it is and how an individual would go about getting it.

Does the story establish the true novelty of the approach?

Satisfactory

The story does a good job of describing the novelty of the test.

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

Satisfactory

Because the story quotes multiple sources, the reader can assume that the story does not rely on a press release as the sole source of information.

Total Score: 9 of 10 Satisfactory

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