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Developing test to warn smokers of cancer danger


3 Star

Developing test to warn smokers of cancer danger

Our Review Summary

A recent paper in the Journal of the National Cancer Institute was entitled, "Gene Expression–Based Prognostic Signatures in Lung Cancer: Ready for Clinical Use?"  The authors concluded, "From our review, it is clear that medical utility for any of the reported prognostic signatures has not yet been convincingly demonstrated. We hope that future research in this important field will strive to move away from being another exercise in clinical correlation to one that truly makes an impact on widespread medical practice." We wish the story had applied more of that kind of context to the coverage of this latest genetic signature. 


Why This Matters

The study reported on is of interest because any early diagnostic tests for lung cancer that worked and were available would have public health importance, given that lung cancer is the leading cause of cancer mortality in the US.  But these findings reported on are very preliminary. 


Does the story adequately discuss the costs of the intervention?

Not Applicable

Not applicable.  Given the early stage of research, it is understandable that costs weren’t estimated.

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

Not Satisfactory

At a very elementary level, the story never reported on what would be the key quantifiable benefit – the sensitivity of the test.  What were the numbers from the trial?

Given the early stage of research, and the fact that we don’t even know if the test will work in broader testing it seems early to speculate on whether the genetic chain reaction could be reversed by a drug, but at least the story referred to this as an "early hint among a handful of people."

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

Not Satisfactory

 Is there any risk in obtaining an endobronchial sample via bronchoscopy?  The story didn’t tell us. And is there any harm from the un-named compund at the end of the story?

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


Our reviewers were split on this one. One felt it should have been emphasized that these were small scale studies that were actually inadequately powered to support the claims made.  

But there was enough cautious language about the evidence for us to give this a satisfactory score. For example:

  • "a test based on the research is being developed"
  • "if the work pans out"
  • "Spira cannot estimate how much lung cancer might come from this genetic pathway"
  • "a preliminary but exciting clue"

Does the story commit disease-mongering?


 No disease-mongering in this story.

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


 A quote from an apparently independent source was included in this story.  Mentioning that Dr. Spira is a co-founder of a company promoting the test and the agent being tested as a treatment provided interesting insight.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

 There was no discussion of how the test described compared with other methods available or under development for detection of lung cancer.

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

Not Satisfactory

 Although the story describes the test as something that is being developed, there is no explicit mention that it is now purely a research tool, is currently not available nor FDA approved for the purpose described. And there is no discussion of the availabilty of the "compound" used.  In fact, it’s not even named.

Does the story establish the true novelty of the approach?

Not Satisfactory

 The story didn’t mention that several companies are following leads on various gene expression signatures as means of early lung cancer detection.  That kind of context would have helped.

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


Given the fact that an independent researcher was interviewed, it does not appear that the story relied solely on a news release. 

Total Score: 4 of 9 Satisfactory


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