This story on a new report out of the Women’s Health Initiative left out a crucial piece of information: the women in this arm of the trial, the estrogen-only arm, had all had hysterectomies.
Most women who enter menopause still have their uterus. These findings don’t apply to them, because estrogen alone is not recommended for them. This story does not make that clear. These new findings from the estrogen-only arm of the trial do not change the breast cancer risk situation for women who are considering combination hormone therapy to relieve their hot flashes and night sweats.
This story includes an interview with a woman who (presumably) took part in the estrogen-alone arm of the Women’s Health Initiative (although that is not explicitly stated). The reporter states that this woman has a family history of breast cancer. That places her at somewhat increased risk of breast cancer (her overall risk depends on a number of other factors, too). The story then goes on to say that estrogen therapy is not recommended for women at high risk of breast cancer–but it is not clear just how ‘high’ is high? Would estrogen even be an option for this woman and others in her situation?
Overall, this story missed an opportunity to explain exactly who can be reassured by these findings and who is not affected by them at all.
Costs of estrogen therapy are not mentioned.
Actual rates of breast cancer among women taking estrogen and those not taking estrogen are not provided. Also did not provide any information on benefits of estrogen for relief of symptoms – which is the reason many take it in the first place.
Story fails to mention several important harms of estrogen-only therapy, including an increased risk of stroke and blood clots. Also not mentioned is the significant increase in abnormal mammograms and breast biopsies among women taking estrogen.
Mis-states the aim of the ‘large government study’ that originally found increased breast cancer risk in women taking estrogen with progesterone. The aim was to assess the impact of hormone therapy on the risk of certain chronic diseases in postmenopausal women. Women in the study were not taking hormones ‘to relieve the symptoms of menopause,’ as the story states.
Story fails to clearly state that the reported findings apply only to women for whom estrogen-only therapy is an option–those who have had a hysterectomy.
No mention of the placebo-controlled nature of the study, nor the fact that this new report includes longer followup data.
The story greatly overstates the number of women who ‘will be going through’ menopause this year. In addition, the story seems to promote a therapy just because it doesn’t cause a side effect – as opposed to promoting it because it really relieves a symptom!
Institutional affiliations of interviewed experts are provided, though no information given about whether they were involved in the study or receive funding from any hormone manufacturer.
No mention of other options for managing the “unpleasant and powerful” symptoms of menopause.
It’s fairly clear from the story that this is not a new therapy.
It’s clear from the story this is not a novel treatment.
Does not appear to have relied solely on a press release. Interviews with experts are cited.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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