Whether to give chemotherapy after surgery for localized colon cancer is controversial. Chemotherapy has significant side effects and the survival benefit is small. As is currently done for breast cancer, to be able to predict whether the tumor is likely to return after surgery would help guide treatment decisions about chemotherapy. This story reports on new results on a gene test for colon cancer tumors to be presented at the American Society of Clinical Oncology meeting.
Unfortunately the new test was only modestly able to predict colon cancer recurrence and failed to predict response to chemotherapy. Future research is clearly needed.
This story adequately represents the novelty and availability of the test. It does not engage in disease mongering and is clear on the target of the test – colon cancers that are large but have not spread beyond the colon. It quotes multiples sources and is clear to point out who is invested in the development of the test.
The story could have been improved by describing what is currently done to determine need for chemotherapy (i.e. pathology and/or imaging tests), by providing the baseline average risk of recurrence as a comparison to the predicted risk from the test, and by describing potential harms of the test.
Finally, the story doesn’t really give any details on the current study or the overall strength of the evidence to support the use of the test. Although the story points out that the results will be presented at a meeting, it should have made the point that these studies are not rigorously peer-reviewed and evaluated prior to presentation, which makes it more difficult to evaluate the study at this time.
The story describes the cost of a similar existing test for breast cancer but is clear to point out that exact costs are not yet available. The story also mentions several times that the high cost of the test may not be worth the expense.
The story does provide a range of percentage risk of having a recurrence. The story could have provided the baseline average risk by way of comparison and could have described what the expected benefit in terms of improved survival could potentially be.
The story does not describe any harms of the test. Because the test does not predict whether an individual would actually benefit from chemotherapy, some people could decide to undergo chemotherapy based on the results of the test without realizing any benefit. The story didn’t explicitly state that potential harm and we think it should have.
The story doesn’t really give any details on the current study or the overall strength of the evidence to support the use of the test. Although the story points out that the results will be presented at a meeting, it should have made the point that these studies are not rigorously peer-reviewed and evaluated prior to presentation, which makes it more difficult to evaluate the study at this time.
The story does not exagerrate the seriousness or prevalence of colon cancer. The story is also clear to describe the target of the test – colon cancers that are large but have not spread beyond the colon.
The story quotes multiple experts.
Clearly not having the test is the alternative. The story did not need to spell that out, but it could have described what is currently done to determine need for chemotherapy, i.e. pathology and/or imaging tests.
The story clearly states that the test is not yet available but that it may be in the near future.
The story adequately describes the novelty of the test.
Because the story quotes multiple experts, it is reasonable to assume that the story does not rely on a press release as the sole source of information. But it does also appear clear that the news release from the American Society of Clinical Oncology meeting is driving the story. Otherwise why not wait until the actual presentation of results – or publication of a peer-reviewed paper?
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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