This article presents information on two studies regarding the competing risks of colorectal cancer and heart disease. The potential for prevention of colorectal cancer were somewhat overstated while the risks associated with heart problems were minimized. Lumping all polyps together without mention of the percentage that are likely to go on to develop into malignancies is a disservice because it exaggerates the cancer risk. In that regard, this story is an example of disease mongering because it fails to make the distinction between colonic polyps and cancerous polyps. The majority of polyps found and removed during the course of colonoscopy are neither malignant nor invasive.
There is no mention of the costs of treatment.
The heart related side effects observed in the two studies are provided in absolute frame (3.4% vs. 2.5% in the first study; 7.5% vs. 4.6% in the second study); the risk of developing polyps was presented as 60% vs. less than 50% in the first study; 49% vs. 34% in the second study). Early in the article, the reduction in polyps is presented as a 33% to 45% reduction. Only the 33% reduction (second study) can be calculated from the information provided. The 45% reduction is found in the press release on the study from the meeting at which it was presented.
The heart-related side effects, listed as heart attacks, stroke, and other serious heart-related problems, are mentioned. No mention was made of the gastrointestinal, renal and hemorrhagic events associated with treatment.
This article reported on results from two randomized, double-blind trials examining the potential for prevention of colorectal adenoma in patients with a history of colorectal neoplasia.
This story is an example of disease mongering because it fails to make the distinction between colonic polyps and cancerous polyps. The majority of polyps found and removed during the course of colonoscopy are neither malignant nor invasive.
No attempt appears to have been made to contact individuals not associated directly with the two studies mentioned, other than a spokesperson from the National Cancer Institute, the agency that funded one of the studies presented.
No other approaches for colorectal adenocarcinoma prevention were presented.
Article states that Celebrex is the only cox-2 inhibitor still on the market. While Celebrex is the only FDA approved cox-2 inhibitor sold, there are a number of approved NSAID medications available which, while not specific for cox-2, inhibit both cox-1 and cox-2.
The proposed use of cycloxygenase inhibition as a preventative treatment for people with mutation in the APC gene and thus at increased risk for colorectal adenoma is not new.
We can’t be sure that the story relied solely or largely on a news releae, but the article did appear to use the press release supplied by the American Association for Cancer Research as a source of information for this story.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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