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Read Original Story

Finding a “silent killer”

Rating

5 Star

Finding a “silent killer”

Our Review Summary

Cancer Antigen 125 (CA-125) is a protein found on the surface of certain types of ovarian cancer cells. The CA-125 test is used to monitor and guide treatment for ovarian cancer but has not been shown to be an effective screening test for average-risk women. This is because the test can come back elevated for many reasons and the false positive rate is high. However, according to new, unpublished results to be presented at next month’s American Society of Clinical Oncology (ASCO) meeting, monitoring change in CA-125 over time and incorporating other factors to identify higher-risk women for additional testing may identify ovarian cancers at a stage when they are treatable.

The full results have not yet been presented or published and a larger, ongoing study in the UK should provide more clarification as to whether this method should be used for widespread screening. Until then, caution should be used in interpreting these results.

This story meets all of the criteria in relatively few words. It provides an adequate description of the current study, quantifies the benefits and harms of the test and compares it to existing alternatives (of which there are none). It does not engage in disease mongering and quotes an independent expert who provides valuable insight.

The story does mention how much the blood test and ultrasound cost, but could have raised the question of whether this might be too expensive given that thousands of women must be tested in order to find one case of ovarian cancer.

 

Why This Matters

Key perspective in the story from Dr. Len Lichtenfeld of the American Cancer Society: “More research and refining needs to be done before it should be implemented. I can remember when doctors all rushed to adopt the Prostate Specific Antigen test, and we still don’t know how to use it.”

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story does mention how much the blood test and ultrasound cost. The story could have raised the question of whether this might be too expensive given that thousands of women must be tested in order to find one case of ovarian cancer.

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

Satisfactory

The story provides the number of cancers identified and false positives.

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

Satisfactory

The story mentions false positive results and unnecessary exploratory surgery as potential harms of the test.

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

Satisfactory

The story adequately describes the current study and provides some much-need caveats in interpreting the results.

Does the story commit disease-mongering?

Satisfactory

The story does not hype the seriousness or prevalence of ovarian cancer. It is a devastating diagnosis.

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

Satisfactory

The story quotes an independent expert from the American Cancer Society who provides much-needed perspective.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story is clear to say that there is no good existing screening method and that using CA-125 alone has been proven inneffective.

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

Satisfactory

The CA-125 test is clearly available. What is not clear is whether the clinical algorithm used in this study to identify high risk women is available widely or only in a research setting.

Does the story establish the true novelty of the approach?

Satisfactory

CA-125 is not new, as it is used to monitor and guide treatment for existing ovarian tumors. Its use as a screening tool for ovarian cancer is highly controversial. What is new is the idea of using a model and CA-125 testing over time to predict risk for ovarian cancer.

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

Satisfactory

Because the story quotes an independent expert and a patient, the reader can assume the story did not rely on a press release as the sole source of information.

Total Score: 10 of 10 Satisfactory

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