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‘Revolutionary’ use for aspirin? May help colon cancer patients

Rating

4 Star

‘Revolutionary’ use for aspirin? May help colon cancer patients

Our Review Summary

(PLEASE NOTE:  THIS IS AN AMENDED VERSION OF THE REVIEW THAT WE FIRST POSTED HOURS AGO.  THE REPORTER HAS POINTED OUT THAT SOME OF THE INFORMATION WE FELT WAS LACKING ACTUALLY APPEARED IN A SIDEBAR TO THE STORY – A SIDEBAR THAT WE MISSED.  SO WE HAVE AMENDED THIS REVIEW AND UPGRADED ITS SCORE. WE NOTE THAT THE REPORTER DID INCLUDE ABSOLUTE RISK REDUCTION FIGURES IN A VERSION OF THE SIDEBAR THAT APPEARED ONLY ON THE USA TODAY WEBSITE.  CURRENTLY WE ONLY REVIEW WHAT APPEARS IN THE PRINT VERSION.  WE NOTE THE REPORTER’S EFFORT TO GET THE ADDITIONAL INFORMATION INTO THE STORY IN SOME FORMAT UNDER TIME PRESSURE.  BUT READERS OF THE NEWSPAPER – NOT OF THE  WEBSITE – RECEIVED ONLY THE INFORMATION WE CRITIQUED. OUR APOLOGIES TO USA TODAY FOR INITIALLY MISSING THE INFORMATION THAT WAS IN THE PRINTED SIDEBAR.) 

USA Today gives readers more actual information about the potential use of aspirin to treat colorectal cancer than CBS did in their story which we also reviewed. The USA Today story includes a number of caveats and pointed out limitations of the study, but it also hypes the findings by using the word “revolutionary” in the headline and by emphasizing relative reductions in death rates, rather than giving a true overall view of how patients fare after getting a diagnosis of colorectal cancer.

While the study is indeed newsworthy, because it analyses a powerful set of data collected over decades, it is a continuation of a long line of investigations into the potential effects of aspirin on colorectal cancer, not some startling break with history.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story noted that aspirin is sold for pennies a pill.

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

Not Satisfactory

The printer version of the story reports only relative risk reductions, ignoring the important point that most colorectal cancer patients in this study survived for many years whether or not they took aspirin after their diagnosis; thus it exaggerates the potential benefits of adding aspirin to the treatment mix. Specifically, the story discussed whether aspirin should get credit for “beating cancer,” although there is nothing in the study about aspirin being a cure. To put the results in context, the story should have mentioned that the 10-year survival rates were 69 percent for those not taking aspirin and 74 percent for those who did take aspirin. (PLEASE NOTE:  ABSOLUTE RISK REDUCTION FIGURES APPEARED IN A WEB VERSION OF THE SIDEBAR BUT WE CURRENTLY REVIEW ONLY WHAT APPEARS IN PRINT.)  

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

Satisfactory

PLEASE NOTE:  WE MISSED THE FACT THAT A SIDEBAR TO THE MAIN STORY DID INCLUDE INFORMATION ON GASTROINTESTINAL BLEEDING.  SO WE HAVE CHANGED THIS GRADE TO SATISFACTORY. 

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

Satisfactory

The story includes several caveats warning that the results of the study are not definitive. It pointed out some of the limitations inherent in this sort of observational study. It also pointed out that a randomized controlled trial would be needed in order to actually prove that aspirin fights cancer.

However, the story highlighted the sharply lower rate of colorectal disease deaths among patients who had a type of colorectal cancer that overproduces the COX-2 enzyme and took aspirin after diagnosis… without mentioning either the wide uncertainty in the number or that the overwhelming majority of patients survived for many years, whether or not they took aspirin. (PLEASE NOTE:  THIS INFORMATION DID NOT MAKE IT INTO THE PRINT VERSION BUT WAS INCLUDED IN AN ONLINE VERSION OF THE STORY.) 

Does the story commit disease-mongering?

Not Applicable

The story did not discuss the prevalence or consequences of colorectal cancer, so we judge this criterion to be not applicable in this case. 

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 this story the benefit of the doubt on this criterion.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

This story does not mention that the overwhelming majority of patients receiving standard therapy for colorectal cancer survive for many years, thus hyping the potential benefits of aspirin. (THE ABSOLUTE RISK REDUCTION FIGURES DID NOT APPEAR IN THE PRINT VERSION OF THE STORY BUT DID APPEAR IN AN ONLINE VERSION. WE CURRENTLY REVIEW ONLY WHAT APPEARS IN PRINT.) 

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

By using the term ‘revolutionary’ to describe the study results, this story ignores the many years of research into the potentially beneficial effects of aspirin on colorectal cancer.

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

Satisfactory

The story included a physician not connected with the study and the reporter apparently interviewed one of the study authors. So it clearly did not rely solely or largely on a news release.

Total Score: 6 of 9 Satisfactory

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