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People susceptible to colon cancer can cut their risk in half by taking aspirin

Rating

3 Star

People susceptible to colon cancer can cut their risk in half by taking aspirin

Our Review Summary

This is a story about a study that found that aspirin decreased the incidence of colorectal cancer in a group of individuals with a specific genetic mutation that predisposed them to develop this cancer.  

While the story meets many of our criteria, we find two gaping holes:

  1. The same group of investigators reported the very opposite outcome less than a year ago (i.e. that aspirin had no effect on the incidence of colorectal cancer in apparently this same group of individuals.)  [New England Journal of Medicine Dec 11 2008; 359(24):2567]  But the story never mentioned this – even though it was even mentioned in the abstract of the talk that we found online.
  2. The story was also confusing in that it did not provide the actual rates of cancer found in the aspirin group and in the placebo group. So it’s impossible to judge the actual scope of the supposed benefit being reported.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

Although a precise cost was not mentioned in the story, aspirin was described as ‘cheap’. That’s OK; we’re confident that people know this.

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

Not Satisfactory

The actual rates of colon cancer were not given.  Circuitously, readers might be able to piece this together – if we can assume that half of the 1,000 people studied got aspirin and half got placebo pills.  So one might assume that six people in about 500 on aspirin got colon cancer versus 16 in about 500 in the placebo group.

But the abstract of the talk which we found online stated that "long term followup data have been accumulated on 628 of the cohort" – so we don’t actually know what the rates were that were presented in the talk. 

This is one of the weaknesses in reporting on studies presented at meetings but not yet published.  

The story needn’t be circuitious and needn’t make readers assume or make them do the math.  

Why not just spell out the actual rates and the actual numbers?  

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

Satisfactory

Although there was no mention of any harms of taking aspirin that were seen during this particular study, the story did mention that "Aspirin can cause significant side effects if not used as directed by a doctor" and the fact that "it can irritate the stomach and intestines and cause major bleeding."

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

Not Satisfactory

The story didn’t make clear that the results haven’t yet been evaluated by the scientific community.  And because the story is based on a talk at a scientific meeting, we could only find an abstract online – an abstract which raises questions in our mind about the actual rates of cancer found – something not made clear in the story.  See criterion for "Quantification of Benefits of Treatment" below.

Does the story commit disease-mongering?

Satisfactory

The story included this quote: "This doesn’t mean that everyone should start taking aspirin if they’re worried about bowel cancer," said Henry Snowcroft of Cancer Research United Kingdom.

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

Satisfactory

The story included comments from clinicians and researchers who were not involved in the study reported.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story did not mention the lack of options for colorectal cancer prevention.  The guidelines about frequency of screening in this particular cohort or the general public were not discussed as part of this story.

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

Satisfactory

The story appropriately reminds readers that "aspirin has been used widely for years to treat minor aches and to alleviate fevers."

Does the story establish the true novelty of the approach?

Not Satisfactory

At the end of last year, the same group of investigators (J Burn, first author) published a paper in the New England Medical Journal which found aspirin had no effect on incidence of colorectal cancer in apparently the same group of individuals with Lynch Syndrome.  

It should have been mentioned that the outcome at 4 years failed to show differences between the group whereas an examination of the data at a later time point may suggest a benefit from the treatment.  "May suggest" is an important point here because it is not clear that the investigators accounted for the fact that the difference reported may have arisen simply by chance.

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

Satisfactory

Because numerous sources were interviewed, it’s safe to assume the story did not rely solely or largely on a news release.

Total Score: 6 of 10 Satisfactory

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