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Read Original Story

Stomach stapling may lower cancer risk in women

Rating

3 Star

Stomach stapling may lower cancer risk in women

Our Review Summary

This story gets the broad brushstrokes right on a new study about bariatric surgery and cancer: It conveys that women who get bariatric surgery appear to have reduced risk of cancer, while men don’t. It puts the findings in context of previous research.

Its greatest strength is the use of two solid quotes, from different sources, indicating that this study leaves a lot of questions unanswered about the obesity-cancer link. 

Still, the story fails on some very basic practices: It fails to mention the treatment’s costs, harms or alternatives. These could easily have been added; they should be included in nearly every story about the benefits of a medical treatment. 

An additional shortcoming: It fails to put what appears to be a large percentage risk reduction into terms a reader can understand.

A 40 percent reduction in cancer risk is a big deal. A drop in risk in this population from 8 percent to 6 percent–that’s still a big deal, but easier for a reader to understand. 

The question that leaps to mind for many readers will be: Can a lower cancer risk be a "tie-breaker" for women considering bariatric surgery? It would have been very useful to hear clinicians’ thoughts on that. 

Which brings us to this:

Take a look at the report on this study that appeared in the Guardian newspaper in the UK, published in partnership with BMJ. It’s a careful, plain-English description of the findings and their implications for the public. It directly addresses that question of applicability. 

The AP report is 556 words. The Guardian’s is 676.

It’s true that the AP story is 18 percent shorter. But it carries an elevated risk of reader misunderstanding.

That’s a risk-benefit tradeoff worth pondering. 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story fails to mention price. Bariatric surgery usually costs $20,000 to $30,000. 

At a time when interest is high in health care reform–and where treatments are increasingly viewed in terms of cost vs. benefit–it’s important for health journalists to cite a procedure’s cost as a matter of course.

This is especially true when findings suggest a benefit. 

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

Not Satisfactory

Hits and misses here, with the misses outweighing the hits.

Hits: The report uses absolute numbers of cancers to demonstrate the differences in risk between the surgery and control groups in women–and the lack of differences in men.

Misses: It fails to say what percentage of people in the two groups got cancer during the study period. Answer: About 8 percent of controls got cancer, compared to 6 percent in the surgery group. That helps put in context the 40 percent risk reduction mentioned in the lede.

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

Not Satisfactory

Big failure here.

The study in question finds a reduction in cancer risk among women who get bariatric surgery. Yet it fails to mention that the surgery itself carries significant risks, among them:

  • blood clots
  • heart and lung problems
  • post-surgical infection, leaking, bleeding and hernia
  • the risks of anesthestia for the very obese
  • weight regain
  • ongoing nutritional deficiencies and, not least,
  • death

Bariatric surgery is seen as the most effective treatment for the severely obese–but risky enough to be considered the "last resort."

The story should have said so. 

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

Satisfactory

The story does an adequate job describing the quality of evidence. 

It mentions the fact that the finding about men–that they didn’t have the same reduction in cancer risk after bariatric surgery as women–may be due to the low numbers of men in the study. It also mentions that the study was funded by makers of diet drugs. 

For extra points, the reporter might have mentioned that the study wasn’t randomized: patients chose whether to get the surgery. And that the larger trial from which this study is drawn is looking at the endpoints of death rather than cancer incidence. Both of these factors can make the findings less conclusive.  

But the reporter wins those extra points back with the paragraph that quotes an independent source saying: "This is one more piece of a complex puzzle"–thereby implying the limitations of the evidence.

Does the story commit disease-mongering?

Satisfactory

No disease-mongering here.

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

Satisfactory

The reporter interviewed two sources: An independent physician representing the American Cancer Society and the lead author of the study.

This is adequate sourcing for the story, just barely.  It would be useful to hear from another independent oncologist, obesity specialist or cancer epidemiologist. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story fails to mention other treatments for obesity [few are effective, and readers should know this], or other ways to reduce cancer risk.

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

Satisfactory

The number of such procedures, and how long they’ve been done, is pretty clear from the article.

Does the story establish the true novelty of the approach?

Not Applicable

No claims are made for the novelty of bariatric surgery.

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 study.

Total Score: 4 of 8 Satisfactory

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