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Studies don’t end prostate cancer test controversy

Rating

5 Star

Studies don’t end prostate cancer test controversy

Our Review Summary

This is a tough assignment for a health journalist: To report in a single news story results of two big, important prostate cancer screening studies that must be considered together yet for many reasons shouldn’t be compared. Add in the fact that these are interim results from ongoing studies on a topic that’s inherently controversial, and you’ve set a high bar for the reporter to clear. 

This AP story manages to do so.

Its greatest strength is that very early on it states that the studies don’t settle the questions about the value of screening, that the research is continuing and that men should still talk to their doctors about whether screening is right for them. It creates adequate context by using a variety of sources and including information about previous findings. 

As the ratings show, the report could have been stronger by:

Providing more detail on the results themselves. These are complicated studies with complicated findings. In an ideal world, this story would be accompanied by a graphic that lays out the essential facts about each. This would help readers understand key similarities and differences more efficiently–and successfully–than several more inches of text could.

Including information about costs. At a time when health care reform is underway, many parties will be looking at the costs, benefits and risks of various procedures. Even when a story isn’t explicitly about financial costs, reporters should keep this in mind. They can provide a real public service by helping readers understand that no treatment is free, and that cost is a necessary factor in public health policy decisions.

Disclosure:  Dr. Michael Barry is quoted in the story.  He is a medical editor for the Foundation for Informed Medical Decision Making, the organization that sponsors this project.  Dr. Barry was not involved in this review in any way.  

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

While these studies examined prostate cancer mortality rates and treatment outcomes, monetary costs are an important part of the larger conversation about the value of screening.

There are significant financial costs associated with population-wide screenings, along with the follow-up diagnostic procedures and treatments that these studies suggest are of little benefit.

The reporter should have referenced costs of screening and treatments at least briefly.

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

Satisfactory

There are two studies involved here, each with its own methodology, outcomes and limitations. Under the circumstances the news report describes the findings adequately, using a broad brush.

The report states that the U.S. study found no decline in death risk in the screened population, while the European study showed a 20 percent reduced risk of death–yet it also documented considerable overtreatment.

The reporter gets points for using the always valuable "number needed to treat" measure to describe the European findings: 48 additional men would need to be treated to prevent one death from prostate cancer. 

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

Satisfactory

The story focuses in part on the harms of overdiagnosis and overtreatment.

 

 

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

Satisfactory

The story is based on results of two high-quality clinical trials, and it describes the methodologies sufficiently. 

The story does an excellent job of laying out the caveats very early: that the results won’t end the controversy over the value of prostate cancer screening; and that the studies continue and may provide clearer answers in the future.

The reporter gets extra points for mentioning too that the two studies aren’t directly comparable. 

Does the story commit disease-mongering?

Satisfactory

The report does nothing to exaggerate the effects of prostate cancer or its treatments.

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

Satisfactory

The reporter includes comments from the lead authors of the two studies, the author of a related editorial in the New England Journal of Medicine, and a physician representing the American Cancer Society.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story adequately explains that screening options include the PSA blood test and the digital rectal exam. 

The story also refers to the options for treatment after a cancer is identified, indicating that "there’s no agreement on the best treatment approach"–watchful waiting, surgery, hormone therapy or radiation.

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

Satisfactory

The wide use of the PSA test is implied throughout the story.

Does the story establish the true novelty of the approach?

Satisfactory

No claims are made for the novelty of the screening techniques or the findings of the study.

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

Satisfactory

The story does not appear to draw directly from press releases of NIH, the Washington University School of Medicine, or others publicizing the results.

Total Score: 9 of 10 Satisfactory

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