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Preventive Surgeries May Be Lifesaver for Women at High Cancer Risk

Rating

3 Star

Preventive Surgeries May Be Lifesaver for Women at High Cancer Risk

Our Review Summary

It is careful to make clear that the potential benefits of preventive surgery seen in the study apply only to women who carry these specific gene mutations. It provides readers with absolute percentages of cancer and death among the women in the study and not merely vague descriptions of the how the women who opted for surgery fared compared to those who did not. However, the story does not give readers much detail about the pros and cons of the options faced by women with these specific gene mutations. It would have been helpful for this story (and the three others we reviewed) to tell readers that the gene mutation is rare. It is present in less than 2 percent of the general population and less than 3 percent of those who have only a single relative who had breast cancer.

 

Why This Matters

Terrible choices deserve careful consideration. While this story acknowledges that a decision to undergo preventive surgery is difficult, it skims over the consequences.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not mention the costs of genetic testing, increased cancer surveillance or surgery.

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

Satisfactory

This story presents a generally positive portrayal of the benefits of preventive surgery. Coupled with the absence of information about harms, the overall impression might be considered out of balance. But the story does not give the impression that surgery eliminates the risk of cancer and it includes cautionary comments, for instance referring to the “very complex set of considerations” facing women who are considered to have a high cancer risk based on genetic test results. The story also includes some of the absolute percentages of women who developed cancer. In sum, then the overall balance seems reasonable.

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

Not Satisfactory

The story calls preventive surgery “drastic,” but it doesn’t provide any details about harms of the procedures. Also, the description of laparoscopic ovary removal makes the procedure seem entirely benign. No mention of how women might think about potential harms such as premature menopause, heart disease, osteoporosis, etc.

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

Satisfactory

The story does not make clear that this study was observational and not a randomized controlled trial comparing the treatment options available to the participants. Nevertheless, because the study behind this story is a large, high-quality research endeavor, we’ll give the story the benefit of the doubt on this criterion.

Does the story commit disease-mongering?

Satisfactory

The story makes clear that the study findings are relevant specifically to women who have been told that they carry BRCA1/2 genetic mutation that substantially increase their risk of cancer. It compares the lifetime risk estimates of women with the mutations and those in the general population. It also includes comments from experts saying that women who have a family history of cancer should talk to their physicians about whether they should consider genetic testing, thus highlighting the distinction between family history and the specific gene mutations looked at in this study. Also, as mentioned in the summary, the gene mutations are present in less than 3 percent of women who have just a single relative who had breast cancer, so the quote urging all women with a family history of breast cancer presents an extremely aggressive position.

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

Satisfactory

The story includes comments from an author of an editorial in the journal who was not involved in this study. Although the story does not report financial or other information about the sources, the study was funded by a variety of grants from public agencies and foundations and neither the researchers nor the editorial writers reported any relevant financial disclosures.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Although the story says the decision to undergo preventive surgery is complex, it does not describe the alternative approaches that women may choose.

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

Not Satisfactory

The story does not mention that the type and quality of genetic testing, genetic counseling, surgery and surveillance offered to women in this study may not be available to women in other settings.

Does the story establish the true novelty of the approach?

Satisfactory

This story doesn’t imply that preventive surgery is new, but it could have pointed out more clearly that the procedure has been offered to certain women for more than a decade.

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

Satisfactory

The story includes comments from interviews with experts and does not appear to rely on a news release.

Total Score: 6 of 10 Satisfactory

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