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Aspirin and Colorectal Cancer

Rating

3 Star

Aspirin and Colorectal Cancer

Our Review Summary

This story presents a reasonable picture of the results of a study linking aspirin treatment to better colon cancer survival, but that assessment may have more to do with the exceptional quality of the study than it does the quality of the story.

The study published in the Journal of the American Medical Association made use of unique data from decades-long tracking of thousands of health care workers. But the story does viewers a disservice by not explaining what makes this study special. Other than noting that the analysis included over 1200 patients, the story tells viewers nothing about what differentiates this study from the many weaker human (or animal) studies that fill the news day after day.

This study is indeed newsworthy, but the presentation is warped as once again it appears that Katie Couric used the newscast to pursue her colon cancer activism. She leads the story by trumpeting the annual death toll of colon cancer, but then nowhere includes any mention of the fact that about 3 out of 4 patients in this study were still alive a decade after their diagnosis. This story emphasizes that the colon cancer death rate was 29 percent lower among patients who took aspirin after their diagnosis without telling viewers that the same numbers could also be used to say that the survival rate is just 5 percent higher… a slant caused by the fact that so many more patients survived than died.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

Although the story did not mention costs, viewers know that aspirin is inexpensive.

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

Not Satisfactory

The story offered viewers only one number: that colon cancer patients who took aspirin were 29 percent less likely to die of the disease. The number is in the study, but the story left out the caveat that it is an estimate and the real figure could be anywhere within a range from 5 percent to 47 percent.

More importantly, the story left out the tremendously important fact that the overwhelming majority of patients lived many years after their diagnosis. The reported 10-year survival rate was 74 percent for those who took aspirin and 69 percent for those who didn’t take aspirin.

Viewers should have been told that aspirin was linked to a boost of 5 percent in 10-year survival odds.

The story should also have highlighted the finding that people who were taking aspirin before their cancer diagnosis apparently got little or no additional benefit from continuing to take aspirin, in order to reduce the number of viewers who mistakenly believe the results endorse the preventive use of aspirin.

What was the absolute risk reduction? 

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

Satisfactory

The story highlighted serious warnings about aspirin causing ulcers, bleeding and other problems.

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

Satisfactory

The study behind the story is unusually strong, so in this case the credence given the results is reasonable.

However, the satisfactory rating may be more the result of happenstance than skill. There was no explanation of what makes this study exceptionally powerful. The study used data from two large, prospective studies that have been tracking the behaviors and health of health care workers for decades. It is a rare trove of data that can provide insights far beyond those produced by most studies. Other than mentioning that the analysis included data on over 1200 patients, the story did not tell viewers why the results are worthy of notice.

If we were too harsh with our "disease-mongering" grade, we are probably too lenient with this one. 

Does the story commit disease-mongering?

Not Satisfactory

This is a tough call.  Katie Couric highlighted an estimate that 50,000 Americans are expected to die from colon cancer this year, but there was no mention of the fact that most colon cancer patients live many years after diagnosis. The portrayal of a colon cancer diagnosis as a prediction of rapid death misleads viewers. A figure (Fig. 2) in the research study article showed that more than 3 out of 4 colon cancer patients were still alive 20 years after diagnosis; a starkly different view than the doom and gloom that Couric presented. Because of Couric’s well-publicized advocacy efforts on behalf of colon cancer awareness, we’re not sure that the best editorial judgment went into the wording of this piece. 

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

Satisfactory

While the story included a quote from a physician who was not connected to the study and even though this study was funded by public money, the story failed to explain what expertise the independent source has or why his opinion was relied upon.

Nonetheless, we give it a satisfactory score on this criterion.  

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Here again, by failing to mention that most patients who receive standard therapy live for many years, and indeed by highlighting only the death toll of colon cancer without ever mentioning high survival rates, this story exaggerated the potential benefit of adding aspirin to the mix.

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

Satisfactory

Aspirin is widely available. However, the study focused on the COX-2 inhibitory action of aspirin and the authors suggested that rather than aspirin becoming a standard part of colon cancer treatment, future treatment might rely on a drug specifically designed to use this pathway to fight cancer.

Does the story establish the true novelty of the approach?

Not Satisfactory

For many years, researchers have been chasing clues that aspirin may reduce colon cancer risk. The story failed to address what’s actually new about this story: that the data from unusually powerful observational studies helps build a case for aspirin (or another COX-2 inhibitor) as a treatment for colon cancer.

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

Satisfactory

The story included a quote from a physician not connected with the study, so it doesn’t appears to be based just on the news release.

Total Score: 5 of 9 Satisfactory

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